A feasibility study of MR elastography in the diagnosis of prostate cancer at 3.0T

MR elastography is a new imaging tool capable of non-invasively assessing the viscoelastic properties of tissues. The clinical application of MR elastography in the diagnosis of prostate cancer remains to be elucidated.

To investigate the feasibility of MR elastography in the diagnosis of prostate cancer at 3.0T, and to assess the elasticity and viscosity of prostate cancer and benign prostatic disease.

Eight patients (63 ± 7.25 years old) with 12 foci of prostate cancer and 10 patients (59 ± 3.25 years old) with 14 foci of prostatitis in the peripheral zone were evaluated by MRE. Ten healthy volunteers (41 ± 4.32 years old) with 18 ROIs in the peripheral zone of the prostate were also assessed with MR elastography as a control group. The results were confirmed by histopathological findings. All examinations were performed on a 3.0T Philips Achieva scanner. MRE was implemented by transmitting low-frequency longitudinal mechanical waves of 100Hz into the prostate with a transducer placed above the pubic bones. The phase images were reconstructed to acquire viscoelastic mapping. T-test was used to compare the mean elasticity and viscosity of prostate cancer and prostatitis. A comparison of prostate cancer and healthy prostate tissue in elasticity was also evaluated. The correlation of elasticity and Gleason scores between prostate cancer and prostatitis were retrospectively analyzed with Pearson Correlation.

The mean elasticity and viscosity were significantly higher in the lesions with prostate cancer (6.55 ± 0.47 kPa, 6.56 ± 0.99 Pa.s, respectively) than in regions with prostatitis (1.99 ± 0.66 kPa, 2.13 ± 0.21 Pa.s). The difference between prostate cancer and prostatitis was statistically significant (t = 19.392, p < 0.01; t = 16.372, p < 0.01). The elasticity and viscosity of the healthy peripheral zone of prostate were 2.26 ± 0.45 kPa, 2.38 ± 0.54 Pa.s, respectively. There also was significant difference in elasticity between prostate cancer and normal peripheral zone (t = 25.136, p < 0.01). In addition, we observed a positive correlation between Gleason scores and elasticity of the prostate cancer (r = 0.913, P < 0.01) in this study.

MR elastography can be used to visualize the difference in stiffness between prostate cancer and benign prostatic disease. It is a new imaging method with potential in the diagnosis of prostate cancer.