The goal of this study was to assess the added value of dynamic contrast-enhanced (DCE) imaging in detecting locally radio-recurrent prostate cancer using multiparametric magnetic resonance imaging (mpMRI) at 3Tesla (T).
We retrospectively analyzed 45 patients with rising prostate-specific antigen level after prostate radiotherapy who underwent mpMRI [T2-weighted (T2w), diffusion-weighted (Dw) and DCE imaging] at 3T before prostate biopsy. Four readers assigned a 5-level Likert score of cancer likelihood in 8 prostate sectors (6 sextants, 2 seminal vesicles) on T2w+Dw and T2w+Dw+DCE images. Biopsy results were used as the standard of reference.
T2w+Dw and T2w+Dw+DCE imaging had similar areas under the receiver operating characteristic curves on per-sector (0.87-0.89 vs. 0.87-0.89; P=0.19-0.78) and per-lobe (0.82-0.94 vs. 0.80-0.91; P=0.21-0.84) analysis. Using a Likert score≥2/5 for diagnosis threshold, T2w+Dw+DCE imaging showed non-significantly higher sensitivities on per-sector (0.56-0.72 vs. 0.52-0.73, P=0.34-0.69) and per-lobe (0.80-0.90 vs. 0.73-0.88; P=0.63-0.99) analysis. It also showed non-significantly lower specificities on per-sector (0.74-0.89 vs. 0.82-0.89; P=0.09-0.99) and per-lobe (0.48-0.81 vs. 0.61-0.84; P=0.10-0.99) analysis. Weighted kappa values were respectively 0.57-0.70 and 0.55-0.66 for T2w+Dw and T2w+Dw+DCE imaging at the sector level, and 0.66-0.83 and 0.58-0.85 at the lobe level.
The use of DCE MR imaging tends to increase sensitivity and decrease specificity for all readers, but the differences are not significant.
Diagnostic and interventional imaging. 2016 Feb 23 [Epub ahead of print]
F Alonzo, C Melodelima, F Bratan, T Vitry, S Crouzet, A Gelet, O Rouvière
Department of urinary and vascular radiology, hôpital Édouard-Herriot, hospices civils de Lyon, Lyon 69437, France., Laboratoire d'écologie Alpine, université Joseph-Fourier, BP 53, Grenoble 38041, France; CNRS, UMR 5553, BP 53, Grenoble 38041, France., Department of urinary and vascular radiology, hôpital Édouard-Herriot, hospices civils de Lyon, Lyon 69437, France; Université de Lyon, Lyon 69003, France; Faculté de médecine Lyon Est, université Lyon 1, Lyon 69003, France; Inserm, U1032, LabTau, Lyon 69003, France., Service d'imagerie, hôpital d'instruction des armées Desgenettes, Lyon 69275, France., Université de Lyon, Lyon 69003, France; Faculté de médecine Lyon Est, université Lyon 1, Lyon 69003, France; Inserm, U1032, LabTau, Lyon 69003, France; Department of urology, hôpital Edouard-Herriot, hospices civils de Lyon, Lyon 69437, France., Université de Lyon, Lyon 69003, France; Faculté de médecine Lyon Est, université Lyon 1, Lyon 69003, France; Inserm, U1032, LabTau, Lyon 69003, France; Department of urology, hôpital Edouard-Herriot, hospices civils de Lyon, Lyon 69437, France., Department of urinary and vascular radiology, hôpital Édouard-Herriot, hospices civils de Lyon, Lyon 69437, France; Université de Lyon, Lyon 69003, France; Faculté de médecine Lyon Est, université Lyon 1, Lyon 69003, France; Inserm, U1032, LabTau, Lyon 69003, France. Electronic address: .