The role of pathology correlation approach in prostate cancer index lesion detection and quantitative analysis with multiparametric MRI - Abstract

RATIONALE AND OBJECTIVES: Development of imaging biomarkers often relies on their correlation with histopathology.

Our aim was to compare two approaches for correlating pathology to multiparametric magnetic resonance (MR) imaging (mpMRI) for localization and quantitative assessment of prostate cancer (PCa) index tumor using whole mount (WM) pathology (WMP) as the reference.

MATERIALS AND METHODS: Patients (N = 30) underwent mpMRI that included diffusion-weighted imaging and dynamic contrast-enhanced (DCE) MRI at 3 T before radical prostatectomy (RP). RP specimens were processed using WM technique (WMP) and findings summarized in a standard surgical pathology report (SPR). Histology index tumor volumes (HTVs) were compared to MR tumor volumes (MRTVs) using two approaches for index lesion identification on mpMRI using annotated WMP slides as the reference (WMP) and using routine SPR as the reference. Consistency of index tumor localization, tumor volume, and mean values of the derived quantitative parameters (mean apparent diffusion coefficient [ADC], Ktrans, and ve) were compared.

RESULTS: Index lesions from 16 of 30 patients met the selection criteria. There was WMP/SRP agreement in index tumor in 13 of 16 patients. ADC-based MRTVs were larger (P < .05) than DCE-based MRTVs. ADC MRTVs were smaller than HTV (P < .005). There was a strong correlation between HTV and MRTV (Pearson ρ > 0.8; P < .05). No significant differences were observed in the mean values of Ktrans and ADC between the WMP and SPR.

CONCLUSIONS: WMP correlation is superior to SPR for accurate localization of all index lesions. The use of WMP is however not required to distinguish significant differences of mean values of quantitative MRI parameters within tumor volume.

Written by:
Fedorov A, Penzkofer T, Hirsch MS, Flood TA, Vangel MG, Masry P, Tempany CM, Mulkern RV, Fennessy FM.   Are you the author?
Department of Radiology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115; Department of Radiology, RWTH Aachen University Hospital, Aachen, Germany; Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Department of Radiology, Boston Children's Hospital, Boston, Massachusetts; Department of Radiology, Dana-Farber Cancer Institute, Boston, Massachusetts.

Reference: Acad Radiol. 2015 Feb 13. pii: S1076-6332(15)00012-4.
doi: 10.1016/j.acra.2014.12.022

PubMed Abstract
PMID: 25683501 Prostate Cancer Section