Quantitative Multiparametric MRI Features and PTEN Expression of Peripheral Zone Prostate Cancer: A Pilot Study

The objective of our study was to investigate associations between quantitative image features of multiparametric MRI of the prostate and PTEN expression of peripheral zone prostate cancer.

A total of 45 peripheral zone cancer foci from 30 patients who had undergone multiparametric prostate MRI before prostatectomy were identified by a genitourinary pathologist and a radiologist who reviewed histologic findings and MR images.

Histologic sections of cancer foci underwent immunohistochemical analysis and were scored according to the percentage of tumor-positive cells expressing PTEN as negative (0-20%), mixed (20-80%), or positive (80-100%). Average and 10th percentile apparent diffusion coefficient (ADC) values, skewness of T2-weighted signal intensity histogram, and quantitative perfusion parameters (i.e., forward volume transfer constant [K(trans)], extravascular extracellular volume fraction [ve], and reverse reflux rate constant between the extracellular space and plasma [kep]) from the Tofts model were calculated for each cancer focus. Associations between the quantitative image features and PTEN expression were analyzed with the Spearman rank correlation coefficient (r).

Analysis of the 45 cancer foci revealed that 21 (47%) were PTEN-positive, 12 (27%) were PTEN-negative, and 12 (27%) were mixed. There was a weak but significant negative correlation between Gleason score and PTEN expression (r = -0.30, p = 0.04) and between kep and PTEN expression (r = -0.35, p = 0.02). There was no significant correlation between other multiparametric MRI features and PTEN expression.

This preliminary study of radiogenomics of peripheral zone prostate cancer revealed weak-but significant-associations between the quantitative dynamic contrast-enhanced MRI feature kep and Gleason score with PTEN expression. These findings warrant further investigation and validation with the aim of using multiparametric MRI to improve risk assessment of patients with prostate cancer.

AJR. American journal of roentgenology. 2016 Mar [Epub]

Stephanie M McCann, Yulei Jiang, Xiaobing Fan, Jianing Wang, Tatjana Antic, Fred Prior, David VanderWeele, Aytekin Oto

1 Department of Radiology, University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637., 1 Department of Radiology, University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637., 1 Department of Radiology, University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637., 1 Department of Radiology, University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637., 2 Department of Pathology, University of Chicago, Chicago, IL., 3 Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO., 4 Department of Medicine, University of Chicago, Chicago, IL., 1 Department of Radiology, University of Chicago, 5841 S Maryland Ave, MC 2026, Chicago, IL 60637.

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