Evolution of multi-parametric MRI quantitative parameters following transrectal ultrasound-guided biopsy of the prostate.

To determine the evolution of prostatic multi-parametric magnetic resonance imaging (mp-MRI) signal following transrectal ultrasound (TRUS)-guided biopsy.

Local ethical permission and informed written consent was obtained from all the participants (n=14, aged 43-69, mean 64 years).

Patients with a clinical suspicion of prostate cancer (PSA range 2. 2-11. 7, mean 6. 2) and a negative (PIRAD 1-2/5) pre-biopsy mp-MRI (pre-contrast T1, T2, diffusion-weighted and dynamic-contrast-enhanced MRI) who underwent 10-core TRUS-guided biopsy were recruited for additional mp-MRI examinations performed at 1, 2 and 6 months post biopsy. We quantified mp-MRI peripheral zone (PZ) and transition zone (TZ) normalized T2 signal intensity (nT2-SI); T1 relaxation time (T10); diffusion-weighted MRI, apparent diffusion coefficient (ADC); dynamic contrast-enhanced MRI, maximum enhancement (ME); slope of enhancement (SoE) and area-under-the-contrast-enhancement-curve at 120 s (AUC120). Significant changes in mp-MRI parameters were identified by analysis of variance with Dunnett's post testing.

Diffuse signal changes were observed post-biopsy throughout the PZ. No significant signal change occurred following biopsy within the TZ. Left and right PZ mean nT2-SI (left PZ: 5. 73, 5. 16, 4. 90 and 5. 12; right PZ: 5. 80, 5. 10, 4. 84 and 5. 05 at pre-biopsy, 1, 2 and 6 months post biopsy, respectively) and mean T10 (left PZ: 1. 02, 0. 67, 0. 78, 0. 85; right PZ: 1. 29, 0. 64, 0. 78, 0. 87 at pre-biopsy, 1, 2 and 6 months post biopsy, respectively) were reduced significantly (P

Significant PZ (but not TZ) T2 signal changes persist up to 6 months post biopsy, whereas PZ and TZ ADC is not significantly altered as early as 1 month post biopsy. Caution must be exercised when interpreting T1- and T2-weighted imaging early post biopsy, whereas ADC images are more likely to maintain clinical efficacy. Prostate Cancer and Prostatic Disease advance online publication, 21 July 2015; doi:10. 1038/pcan. 2015. 33.

Prostate cancer and prostatic diseases. 2015 Jul 21 [Epub ahead of print]

A Latifoltojar, N Dikaios, A Ridout, C Moore, R Illing, A Kirkham, S Taylor, S Halligan, D Atkinson, C Allen, M Emberton, S Punwani

Centre for Medical Imaging, University College London, London, UK. , Centre for Medical Imaging, University College London, London, UK. , Department of Urology, University College London Hospital, London, UK. , Department of Urology, University College London Hospital, London, UK. , Department of Radiology, University College London Hospital, London, UK. , Department of Radiology, University College London Hospital, London, UK. , 1] Centre for Medical Imaging, University College London, London, UK [2] Department of Radiology, University College London Hospital, London, UK. , 1] Centre for Medical Imaging, University College London, London, UK [2] Department of Radiology, University College London Hospital, London, UK. , Centre for Medical Imaging, University College London, London, UK. , Department of Radiology, University College London Hospital, London, UK. , Department of Urology, University College London Hospital, London, UK. , 1] Centre for Medical Imaging, University College London, London, UK [2] Department of Radiology, University College London Hospital, London, UK.

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