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A Pilot Study of Multidimensional Diffusion MRI for Assessment of Tissue Heterogeneity in Prostate Cancer
Objectives:
The objectives of this exploratory study were to investigate the feasibility of multidimensional diffusion magnetic resonance imaging (MddMRI) in assessing diffusion heterogeneity at both a macroscopic and microscopic level in prostate cancer (PCa).
Materials And Methods:
Informed consent was obtained from 46 subjects who underwent 3.0-T prostate multiparametric MRI, complemented with a prototype spin echo-based MddMRI sequence in this institutional review board-approved study. Prostate cancer tumors and comparative normal tissue from each patient were contoured on both apparent diffusion coefficient and MddMRI-derived mean diffusivity (MD) maps (from which microscopic diffusion heterogeneity [MKi] and microscopic diffusion anisotropy were derived) using 3D Slicer. The discriminative ability of MddMRI-derived parameters to differentiate PCa from normal tissue was determined using the Friedman test. To determine if tumor diffusion heterogeneity is similar on macroscopic and microscopic scales, the linear association between SD of MD and mean MKi was estimated using robust regression (bisquare weighting). Hypothesis testing was 2 tailed; P values less than 0.05 were considered statistically significant.
Results:
All MddMRI-derived parameters could distinguish tumor from normal tissue in the fixed-effects analysis (P < 0.0001). Tumor MKi was higher (P < 0.05) compared with normal tissue (median, 0.40; interquartile range, 0.29-0.52 vs 0.20-0.18; 0.25), as was tumor microscopic diffusion anisotropy (0.55; 0.36-0.81 vs 0.20-0.15; 0.28). The MKi could not be predicted (no significant association) by SD of MD. There was a significant correlation between tumor volume and SD of MD (R2 = 0.50, slope = 0.008 μm2/ms per millimeter, P < 0.001) but not between tumor volume and MKi.
Conclusions:
This explorative study demonstrates that MddMRI provides novel information on MKi and microscopic anisotropy, which differ from measures at the macroscopic level. MddMRI has the potential to characterize tumor tissue heterogeneity at different spatial scales.
Insights
Multidimensional diffusion MRI (MddMRI) shows promise in prostate cancer (PCa) research by revealing microscopic diffusion heterogeneity (MKi) distinct from macroscopic measures. This technique offers potential for detailed tumor characterization.
Area of Science:
- Radiology
- Oncology
- Biophysics
Background:
- Prostate cancer (PCa) diagnosis and characterization rely on imaging techniques.
- Assessing tumor heterogeneity is crucial for understanding PCa behavior.
- Existing diffusion MRI methods may not fully capture microscopic tissue properties.
Purpose of the Study:
- To explore the feasibility of multidimensional diffusion MRI (MddMRI) in prostate cancer (PCa).
- To assess diffusion heterogeneity at both macroscopic and microscopic levels in PCa.
- To differentiate PCa tissue from normal tissue using MddMRI-derived parameters.
Main Methods:
- 46 subjects underwent 3.0-T multiparametric MRI with a prototype spin echo-based MddMRI sequence.
- Prostate tumors and normal tissue were contoured on ADC and MddMRI-derived maps.
- MddMRI-derived parameters, including microscopic diffusion heterogeneity (MKi), were analyzed for discriminative ability.
Main Results:
- All MddMRI parameters significantly distinguished tumor from normal tissue (P < 0.0001).
- Tumor MKi and microscopic diffusion anisotropy were significantly higher in PCa compared to normal tissue.
- Tumor volume correlated with macroscopic diffusion measures (SD of MD) but not with MKi.
Conclusions:
- MddMRI provides novel insights into MKi and microscopic anisotropy, differing from macroscopic measures.
- MddMRI has the potential to characterize tumor tissue heterogeneity across different spatial scales.
- This technique may enhance the understanding and characterization of prostate cancer.
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