Characteristics of undetected prostate cancer on diffusion-weighted MR Imaging at 3-Tesla with a b-value of 2000s/mm2: Imaging-pathologic correlation - Abstract

OBJECTIVE: To assess the accuracy of Diffusion-Weighted MR Imaging (DW-MRI) at 3-Teslas (3T) with a b-value of 2000s/mm2 (b-2000 DW-MRI) to detect prostate cancer (PCa) and to describe the histological features of missed tumors.

METHODS: Prior to radical prostatectomy, 35 patients with a mean age of 64±6.2years old [51-77years old] had a b-2000 DW-MRI at 3-T, without rectal coil (acquisition time: 2min, 15s), and were analysed on an eight-sector basis by two independent readers blinded to the rest of the multiparametric-MRI protocol. Pathological tumor foci were matched with high intensity focal areas on MRI and correlated for Gleason score, sector location and largest axial diameter.

RESULTS: Of the 280 sectors analysed, histology showed PCa in 113 (113/280, 40%). Overall DW-MRI sensitivity, specificity and accuracy for tumor detection were 79-81%, 99-95% and 92-82% for readers 1 and 2, respectively (kappa test: 0.78). Of all, 28 (28/113, 25%) and 22 (22/113, 20%) tumor foci were not detected by reader 1 and 2 respectively. These undetected tumor foci had a mean pathological axial axis of 5mm (range: 3-15mm) and a Gleason score of 6, 7 (3+4), 7 (4+3) and >7 in 15/28 (54%), 9/28 (32%), 3/28 (10%) and 1/28 (4%) of cases for reader 1, and in 11 (50%), 5 (23%), 5 (23%) and 1 (4%) of cases for reader 2.

CONCLUSION: A normal b-2000 DW-MRI at 3-T may miss small tumors without or with a minor Gleason 4 component.

Written by:
Barral M, Cornud F, Neuzillet Y, Lonchampt E, Lassalle L, Delonchamp NB, Scherrer A.   Are you the author?
Department of Body Imaging, université de Versailles Saint-Quentin-en-Yvelines, hôpital Foch, 40, rue Worth, 92150 Suresnes, France; Department of Radiology A, université Paris-Descartes, hôpital Cochin, AP-HP, 75014 Paris, France; Department of Urology, université de Versailles Saint-Quentin-en-Yvelines, hôpital Foch, 92150 Suresnes, France; Department of Pathology, université de Versailles Saint-Quentin-en-Yvelines, hôpital Foch, 92150 Suresnes, France; Department of Urology, université Paris-Descartes, hôpital Cochin, AP-HP, 75014 Paris, France.  

Reference: Diagn Interv Imaging. 2015 Apr 28. pii: S2211-5684(15)00128-X.
doi: 10.1016/j.diii.2015.03.004


PubMed Abstract
PMID: 25934182

UroToday.com Prostate Cancer Section

E-Newsletters

Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.

Subscribe