Incremental value of diffusion weighted and dynamic contrast enhanced MRI in the detection of locally recurrent prostate cancer after radiation treatment: Preliminary results - Abstract

Department of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.


To assess the incremental value of diffusion-weighted (DW-MRI) and dynamic contrast-enhanced MRI (DCE-MRI) to T2-weighted MRI (T2WI) in detecting locally recurrent prostate cancer after radiotherapy.

Twenty-four patients (median age, 70 years) with a history of radiotherapy-treated prostate cancer underwent multi-parametric MRI (MP-MRI) and transrectal prostate biopsy. Two readers independently scored the likelihood of cancer on a 1-5 scale, using T2WI alone and then adding DW-MRI and DCE-MRI. Areas under receiver operating characteristic curves (AUCs) were estimated at the patient and prostate-side levels. The apparent diffusion coefficient (ADC) from DW-MRI and the K(trans), k(ep), v(e), AUGC90 and AUGC180 from DCE-MRI were recorded.

Biopsy was positive in 16/24 (67%) and negative in 8/24 (33%) patients. AUCs for readers 1 and 2 increased from 0.64 and 0.53 to 0.95 and 0.86 with MP-MRI, at the patient level, and from 0.73 and 0.66 to 0.90 and 0.79 with MP-MRI, at the prostate-side level (p values < 0.05). Biopsy-positive and biopsy-negative prostate sides differed significantly in median ADC [1.44 vs. 1.68 (×10(-3) mm(2)/s)], median K(trans) [1.07 vs. 0.34 (1/min)], and k(ep) [2.06 vs 1.0 (1/min)] (p values < 0.05).

MP-MRI was significantly more accurate than T2WI alone in detecting locally recurrent prostate cancer after radiotherapy.

Written by:
Akin O, Gultekin DH, Vargas HA, Zheng J, Moskowitz C, Pei X, Sperling D, Schwartz LH, Hricak H, Zelefsky MJ.   Are you the author?

Reference: Eur Radiol. 2011 May 1. Epub ahead of print.
doi: 10.1007/s00330-011-2130-6

PubMed Abstract
PMID: 21533634 Prostate Cancer Section