T2* relaxation time in the detection and assessment of aggressiveness of peripheral zone cancer in comparison with diffusion-weighted imaging

AIM - To investigate the feasibility of T2* relaxation time for distinguishing benign from malignant regions, as well as tumour aggressiveness, within the peripheral zone (PZ) of the prostate in comparison with diffusion-weighted imaging (DWI).

MATERIALS AND METHODS - Fifty-eight patients with prostate cancer underwent 3 T magnetic resonance imaging using multi-echo T2* and DWI (maximum b-value, 2000 s/mm(2)). Parametric maps were obtained for apparent diffusion coefficient (ADC) and T2* values. Two radiologists reviewed these maps and measured ADC and T2* values in sextants positive for cancer at biopsy. Data were analysed using mixed-model analysis of variance and receiver operating characteristic curves.

RESULTS - Ninety-three sextants exhibited a Gleason score of 6; 59 exhibited a Gleason score of 7 or 8. The T2* value was significantly lower in cancerous sextants than in the benign PZ (48. 69+0. 60 versus 74. 14+0. 56, p<0. 001), as well as in cancerous sextants with higher rather than lower Gleason scores (43. 18+0. 89 versus 52. 18+0. 55, p<0. 001). The T2* value showed significantly greater specificity for differentiating cancerous sextants from benign PZ than ADC (93. 1% versus 89. 7%, p<0. 001), with equal sensitivity (82. 8% versus 81%, p>0. 05). The T2* value exhibited significantly greater sensitivity and specificity for differentiating sextants with low- and high-grade cancer than ADC (79. 6% versus 64. 5% and 81. 4% versus 72. 9%, respectively; p<0. 05). The T2* value had a significantly greater area under the receiver operating characteristic curve for differentiating sextants with low- and high-grade cancer than ADC (0. 77 versus 0. 71, p<0. 01).

CONCLUSIONS - Preliminary findings suggest that the T2* relaxation time has increased diagnostic value compared with DWI in prostate PZ cancer assessment.

Clinical radiology. 2016 Jan 25 [Epub ahead of print]

L-M Wu, B Zhou, Q Lu, S-T Suo, Q Liu, J Hu, E M Haccke, X-X Chen, J-R Xu

Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China. , Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China. , Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China. , Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China. , Department of Pathology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China. , Department of Radiology, Wayne State University, Detroit, MI 48201, USA. , Department of Radiology, Wayne State University, Detroit, MI 48201, USA. , Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China. , Department of Radiology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China. 

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