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Detection of locally radio-recurrent prostate cancer at multiparametric MRI: Can dynamic contrast-enhanced imaging be

F Alonzo1, C Melodelima2, F Bratan3

  • 1Department of urinary and vascular radiology, hôpital Édouard-Herriot, hospices civils de Lyon, Lyon 69437, France.

Diagnostic and Interventional Imaging
|March 2, 2016
PubMed
Abstract

Insights

Dynamic contrast-enhanced (DCE) MRI slightly increases sensitivity for detecting recurrent prostate cancer but does not significantly improve diagnostic accuracy compared to standard multiparametric MRI. Further research may explore its role in specific clinical scenarios.

Area of Science:

  • Radiology
  • Oncology
  • Medical Imaging

Background:

  • Prostate cancer recurrence after radiotherapy can be challenging to detect.
  • Multiparametric MRI (mpMRI) is a key tool for assessing recurrence.
  • The added value of dynamic contrast-enhanced (DCE) imaging within mpMRI requires further clarification.

Purpose of the Study:

  • To evaluate the additional diagnostic value of DCE-MRI in detecting locally radio-recurrent prostate cancer.
  • To compare the performance of mpMRI with and without DCE imaging at 3 Tesla (T).

Main Methods:

  • Retrospective analysis of 45 patients with rising PSA post-radiotherapy.
  • mpMRI including T2-weighted (T2w), diffusion-weighted (Dw), and DCE imaging at 3T.
  • Four readers assessed cancer likelihood using Likert scores in prostate sectors and lobes, with biopsy as reference.

Main Results:

  • Areas under the ROC curves were similar for T2w+Dw and T2w+Dw+DCE imaging (per-sector: 0.87-0.89; per-lobe: 0.82-0.94).
  • DCE imaging showed non-significantly higher sensitivity (per-sector: 0.52-0.73 vs. 0.56-0.72; per-lobe: 0.73-0.88 vs. 0.80-0.90) and lower specificity (per-sector: 0.82-0.89 vs. 0.74-0.89; per-lobe: 0.61-0.84 vs. 0.48-0.81).
  • Inter-reader agreement (weighted kappa) was comparable between the two imaging protocols.

Conclusions:

  • DCE-MRI imaging tends to increase sensitivity and decrease specificity for detecting radio-recurrent prostate cancer, but these changes are not statistically significant.
  • The addition of DCE imaging to T2w and Dw sequences does not significantly improve the diagnostic performance of mpMRI for recurrent prostate cancer.
Keywords:
Dynamic contrast-enhanced MRIMultiparametric MRINeoplasm recurrenceProstatic neoplasmsRadiotherapy

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