In vivo prostate cancer detection and grading using restriction spectrum imaging-MRI.

BACKGROUND - Magnetic resonance imaging (MRI) is emerging as a robust, noninvasive method for detecting and characterizing prostate cancer (PCa), but limitations remain in its ability to distinguish cancerous from non-cancerous tissue.

We evaluated the performance of a novel MRI technique, restriction spectrum imaging (RSI-MRI), to quantitatively detect and grade PCa compared with current standard-of-care MRI.

METHODS - In a retrospective evaluation of 33 patients with biopsy-proven PCa who underwent RSI-MRI and standard MRI before radical prostatectomy, receiver-operating characteristic (ROC) curves were performed for RSI-MRI and each quantitative MRI term, with area under the ROC curve (AUC) used to compare each term's ability to differentiate between PCa and normal prostate. Spearman rank-order correlations were performed to assess each term's ability to predict PCa grade in the radical prostatectomy specimens.

RESULTS - RSI-MRI demonstrated superior differentiation of PCa from normal tissue, with AUC of 0. 94 and 0. 85 for RSI-MRI and conventional diffusion MRI, respectively (P=0. 04). RSI-MRI also demonstrated superior performance in predicting PCa aggressiveness, with Spearman rank-order correlation coefficients of 0. 53 (P=0. 002) and -0. 42 (P=0. 01) for RSI-MRI and conventional diffusion MRI, respectively, with tumor grade.

CONCLUSIONS - RSI-MRI significantly improves upon current noninvasive PCa imaging and may potentially enhance its diagnosis and characterization. Prostate Cancer and Prostatic Diseases advance online publication, 12 January 2016; doi:10. 1038/pcan. 2015. 61.

Prostate cancer and prostatic diseases. 2016 Jan 12 [Epub ahead of print]

K C McCammack, C J Kane, J K Parsons, N S White, N M Schenker-Ahmed, J M Kuperman, H Bartsch, R S Desikan, R A Rakow-Penner, D Adams, M A Liss, R F Mattrey, W G Bradley, D J A Margolis, S S Raman, A Shabaik, A M Dale, D S Karow

Department of Radiology, University of California San Diego School of Medicine, San Diego, CA, USA. , Department of Urology, University of California San Diego School of Medicine, San Diego, CA, USA. , Department of Urology, University of California San Diego School of Medicine, San Diego, CA, USA. , Department of Radiology, University of California San Diego School of Medicine, San Diego, CA, USA. , Department of Radiology, University of California San Diego School of Medicine, San Diego, CA, USA. , Department of Radiology, University of California San Diego School of Medicine, San Diego, CA, USA. , Department of Radiology, University of California San Diego School of Medicine, San Diego, CA, USA. , Department of Radiology, University of California San Diego School of Medicine, San Diego, CA, USA. , Department of Radiology, University of California San Diego School of Medicine, San Diego, CA, USA. , Department of Pathology, University of California San Diego School of Medicine, San Diego, CA, USA. , Department of Urology, University of Texas San Antonio School of Medicine, San Antonio, TX, USA. , Department of Radiology, University of California San Diego School of Medicine, San Diego, CA, USA. , Department of Radiology, University of California San Diego School of Medicine, San Diego, CA, USA. , Department of Radiology, University of California Los Angeles Geffen School of Medicine, Los Angeles, CA, USA. , Department of Radiology, University of California Los Angeles Geffen School of Medicine, Los Angeles, CA, USA. , Department of Pathology, University of California San Diego School of Medicine, San Diego, CA, USA. , Department of Radiology, University of California San Diego School of Medicine, San Diego, CA, USA. , Department of Radiology, University of California San Diego School of Medicine, San Diego, CA, USA.

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