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Published on: September 3, 2013
Washout gradient in dynamic contrast-enhanced MRI is associated with tumor aggressiveness of prostate cancer
Yu-Jen Chen1, Woei-Chyn Chu, Yeong-Shiau Pu
1Institute of Biomedical Engineering, National Yang-Ming University, Taipei, Taiwan.
Purpose:
To investigate the associations between dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) parameters and the Gleason score (GS) for prostate cancer (PCA) with localization information provided by concurrent apparent diffusion coefficient (ADC) maps.
Materials And Methods:
Forty-three male patients received MR scans, including diffusion tensor imaging (DTI) and DCE MRI, on a 1.5 T MR system. All patients were confirmed to have PCA in the following biopsy within 2 weeks. ADC maps calculated from DTI were used to colocalize cancerous and noncancerous regions on DCE MRI for perfusion analysis retrospectively. Semiquantitative parameters (peak enhancement, initial gradient, and washout gradient [WG] and quantitative parameters [K(trans) , ν(e) , and k(ep) ]) were calculated and correlated with the GS. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of the perfusion parameters in assessing the aggressiveness of PCA.
Results:
A total of 41 PCA nodules were included in the analysis. Among all quantitative and semiquantitative parameters, only WG showed significant correlation with GS (r = -0.75, P < 0.0001). By defining tumor aggressiveness as a GS >6, WG demonstrated a good diagnostic performance, with the area under the ROC curve being 0.88. Under a cutoff point of WG = 0.125 min(-1) , the sensitivity and specificity were 0.87 and 0.78, respectively.
Conclusion:
WG shows a significant association with GS and good diagnostic performance in assessing tumor aggressiveness. Therefore, WG is a potential marker of GS.
Insights
Washout gradient (WG) derived from dynamic contrast-enhanced MRI shows a strong association with Gleason score in prostate cancer. This parameter demonstrates good diagnostic performance in assessing tumor aggressiveness, making it a potential marker for Gleason score.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Prostate cancer (PCA) grading relies on Gleason score (GS).
- Accurate grading is crucial for treatment decisions.
- Non-invasive imaging biomarkers are needed to assess PCA aggressiveness.
Purpose of the Study:
- To investigate the association between dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) parameters and prostate cancer Gleason score (GS).
- To evaluate the utility of DCE MRI parameters, localized using apparent diffusion coefficient (ADC) maps, in assessing PCA aggressiveness.
Main Methods:
- 43 male patients with confirmed PCA underwent 1.5 T MRI, including diffusion tensor imaging (DTI) and DCE MRI.
- ADC maps from DTI were used to co-localize cancerous regions on DCE MRI for perfusion analysis.
- Quantitative (Ktrans, ve, kep) and semiquantitative (peak enhancement, initial gradient, washout gradient [WG]) parameters were calculated and correlated with GS.
Main Results:
- Washout gradient (WG) showed a significant negative correlation with GS (r = -0.75, P < 0.0001).
- WG demonstrated good diagnostic performance for identifying aggressive PCA (GS >6), with an area under the ROC curve of 0.88.
- A cutoff of WG = 0.125 min(-1) yielded sensitivity of 0.87 and specificity of 0.78.
Conclusions:
- Washout gradient (WG) is significantly associated with Gleason score in prostate cancer.
- WG exhibits strong diagnostic performance in assessing tumor aggressiveness.
- WG shows potential as a non-invasive imaging biomarker for prostate cancer Gleason score.
