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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
Diffusion-weighted and dynamic contrast-enhanced MRI of prostate cancer: correlation of quantitative MR parameters
Aytekin Oto1, Cheng Yang, Arda Kayhan
1Department of Radiology, University of Chicago, IL 60637, USA. aoto@radiology.bsd.uchicago.edu
Objective:
The objective of our study was to investigate whether quantitative parameters derived from diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) correlate with Gleason score and angiogenesis of prostate cancer.
Materials And Methods:
Seventy-three patients who underwent preoperative MRI and radical prostatectomy were included in our study. A radiologist and pathologist located the dominant tumor on the MR images based on histopathologic correlation. For each dominant tumor, the apparent diffusion coefficient (ADC) value and quantitative DCE-MRI parameters (i.e., contrast agent transfer rate between blood and tissue [K(trans)], extravascular extracellular fractional volume [v(e)], contrast agent backflux rate constant [k(ep)], and blood plasma fractional volume on a voxel-by-voxel basis [v(p)]) were calculated and the Gleason score was recorded. The mean blood vessel count, mean vessel area fraction, and vascular endothelial growth factor (VEGF) expression of the dominant tumor were determined using CD31, CD34, and VEGF antibody stains. Spearman correlation analysis between MR and histopathologic parameters was conducted.
Results:
The mean tumor diameter was 15.2 mm (range, 5-28 mm). Of the 73 prostate cancer tumors, five (6.8%) had a Gleason score of 6, 46 (63%) had a Gleason score of 7, and 22 (30.1%) had a Gleason score of greater than 7. ADC values showed a moderate negative correlation with Gleason score (r = -0.376, p = 0.001) but did not correlate with tumor angiogenesis parameters. Quantitative DCE-MRI parameters did not show a significant correlation with Gleason score or VEGF expression (p > 0.05). Mean blood vessel count and mean vessel area fraction parameters estimated from prostate cancer positively correlated with k(ep) (r = 0.440 and 0.453, respectively; p = 0.001 for both).
Conclusion:
There is a moderate correlation between ADC values and Gleason score and between k(ep) and microvessel density of prostate cancer. Although the strength of the correlations is insufficient for immediate diagnostic utility, these results warrant further investigation on the potential of multiparametric MRI to facilitate noninvasive assessment of prostate cancer aggressiveness and angiogenesis.
Insights
Quantitative MRI parameters show a moderate correlation with prostate cancer aggressiveness. Apparent diffusion coefficient (ADC) values correlate with Gleason score, and a DCE-MRI parameter correlates with microvessel density, suggesting potential for noninvasive assessment.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Prostate cancer aggressiveness is crucial for treatment decisions.
- Accurate noninvasive assessment of tumor characteristics is needed.
Purpose of the Study:
- To investigate correlations between quantitative MRI parameters (DWI and DCE-MRI) and prostate cancer Gleason score and angiogenesis.
Main Methods:
- Seventy-three patients underwent preoperative MRI.
- Apparent diffusion coefficient (ADC) and dynamic contrast-enhanced MRI (DCE-MRI) parameters were calculated.
- Histopathologic correlation included Gleason score, microvessel count, and VEGF expression.
Main Results:
- ADC values showed a moderate negative correlation with Gleason score (r = -0.376, p = 0.001).
- DCE-MRI parameter k(ep) positively correlated with microvessel density (r = 0.440-0.453, p = 0.001).
- No significant correlation was found between DCE-MRI parameters and Gleason score or VEGF expression.
Conclusions:
- Moderate correlations exist between ADC values and Gleason score, and k(ep) and microvessel density in prostate cancer.
- While not yet diagnostically sufficient, these findings support further research into multiparametric MRI for assessing prostate cancer aggressiveness and angiogenesis.
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