PURPOSE: The aim of the study was the comparison of the diagnostic potential of dynamic contrast-enhanced magnetic resonance imaging to differentiate between prostate carcinoma and normal prostate tissue as well as prostatitis at 2 different field strengths: 1.5 versus 3 T.
METHODS: Sixty-six patients with biopsy and/or prostatectomy of the prostate were included in the study. Magnetic resonance imaging was performed at 1.5 T in 20 patients with biopsy-proven prostate cancer (PC) and in 8 patients with prostatitis; at 3 T, we analyzed 27 patients with prostatectomy-proven PC and 11 patients with prostatitis. All examinations were performed using a combined body and endorectal coil protocol and a 2-dimensional TurboFLASH T1-weighted gradient echo sequence to calculate plasma flow (PF) and mean transit time (MTT) values. A total of 28 of 38 areas of normal prostate tissue, 20 of 27 areas of PC, and 8 of 11 prostatitis were analyzed at 1.5 or 3T. For the normalization, we calculated PC/normal and prostatitis/normal tissue ratios of PF and MTT for each patient.
RESULTS: Prostate cancer showed higher PF (P < 0.0001) and shorter MTT (P < 0.0001) at 3 T and at 1.5 T (P < 0.0001 for PF and P = 0.0016 for MTT) compared with the normal tissue. In comparison with the normal tissue, prostatitis had a statistically significant higher PF at 1.5 T (P = 0.0156) but not at 3 T (P = 0.17) and no significantly shorter MTT values both at 3 (P = 0.15) and 1.5 T (P = 0.25). Sensitivity and specificity for differentiating PC from prostatitis with PF were 46% and 88% at 1.5 T (cutoff ratio, 2.3) and 89% and 73% at 3 T (cutoff ratio, 1.2), respectively. Sensitivity and specificity for MTT were 77% and 100% at 1.5 T (cutoff ratio, 0.7) and 70% and 100% at 3 T (cutoff ratio, 0.6), respectively. We found no significant relationship between the Gleason score and PF/MTT (P = 0.17/0.11 for 1.5 T and P = 0.23/0.18 for 3 T).
CONCLUSIONS: The differentiation between PC and the normal tissue is possible with both field strengths. Prostate cancer can be better distinguished from prostatitis at 3 T compared with 1.5 T. The differentiation between prostatitis and the normal tissue is limited at both field strengths.
Written by:
Sertdemir M, Schoenberg SO, Sourbron S, Hausmann D, Heinzelbecker J, Michaely HJ, Dinter DJ, Weidner AM. Are you the author?
Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; Division of Medical Physics, University of Leeds, Leeds, United Kingdom; Department of Urology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany.
Reference: Invest Radiol. 2013 Feb;48(2):92-7.
doi: 10.1097/RLI.0b013e31827bbcbe
PubMed Abstract
PMID: 23249646
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