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Published on: October 10, 2019
Multiparametric 3T prostate magnetic resonance imaging to detect cancer: histopathological correlation using
Baris Turkbey1, Haresh Mani, Vijay Shah
1Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
Purpose:
We determined the prostate cancer detection rate of multiparametric magnetic resonance imaging at 3T. Precise one-to-one histopathological correlation with magnetic resonance imaging was possible using prostate magnetic resonance imaging based custom printed specimen molds after radical prostatectomy.
Materials And Methods:
This institutional review board approved prospective study included 45 patients (mean age 60.2 years, range 49 to 75) with a mean prostate specific antigen of 6.37 ng/ml (range 2.3 to 23.7) who had biopsy proven prostate cancer (mean Gleason score of 6.7, range 6 to 9). Before prostatectomy all patients underwent prostate magnetic resonance imaging using endorectal and surface coils on a 3T scanner, which included triplane T2-weighted magnetic resonance imaging, apparent diffusion coefficient maps of diffusion weighted magnetic resonance imaging, dynamic contrast enhanced magnetic resonance imaging and spectroscopy. The prostate specimen was whole mount sectioned in a customized mold, allowing geometric alignment to magnetic resonance imaging. Tumors were mapped on magnetic resonance imaging and histopathology. Sensitivity, specificity, positive predictive value and negative predictive value of magnetic resonance imaging for cancer detection were calculated. In addition, the effects of tumor size and Gleason score on the sensitivity of multiparametric magnetic resonance imaging were evaluated.
Results:
The positive predictive value of multiparametric magnetic resonance imaging to detect prostate cancer was 98%, 98% and 100% in the overall prostate, peripheral zone and central gland, respectively. The sensitivity of magnetic resonance imaging sequences was higher for tumors larger than 5 mm in diameter as well as for those with higher Gleason scores (greater than 7, p <0.05).
Conclusions:
Prostate magnetic resonance imaging at 3T allows for the detection of prostate cancer. A multiparametric approach increases the predictive power of magnetic resonance imaging for diagnosis. In this study accurate correlation between multiparametric magnetic resonance imaging and histopathology was obtained by the patient specific, magnetic resonance imaging based mold technique.
Insights
Multiparametric 3T MRI accurately detects prostate cancer. A novel mold technique ensured precise correlation between MRI scans and prostatectomy specimens, improving diagnostic accuracy for tumors.
Area of Science:
- Radiology
- Oncology
- Pathology
Background:
- Prostate cancer diagnosis relies on accurate imaging.
- Multiparametric MRI offers detailed prostate visualization.
Purpose of the Study:
- To determine the prostate cancer detection rate of 3T multiparametric MRI.
- To establish precise histopathological correlation using custom MRI-based molds.
Main Methods:
- Prospective study of 45 biopsy-proven prostate cancer patients undergoing 3T MRI before prostatectomy.
- Utilized triplane T2-weighted, diffusion-weighted, dynamic contrast-enhanced MRI, and spectroscopy.
- Custom molds enabled precise geometric alignment of prostatectomy specimens to MRI for whole-mount sectioning and tumor mapping.
Main Results:
- High positive predictive value (98-100%) for prostate cancer detection across different prostate zones.
- MRI sensitivity increased for tumors >5mm and Gleason score >7.
- Accurate correlation between MRI findings and histopathology was achieved.
Conclusions:
- 3T multiparametric MRI is effective for prostate cancer detection.
- The MRI-based mold technique facilitates accurate correlation with histopathology.
- This approach enhances the diagnostic power of MRI for prostate cancer.
