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Updated: Jul 15, 2025
A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
Quantitative Dynamic Contrast-Enhanced Magnetic Resonance Parameters Could Predict International Society of
Chun-Bi Chang1,2, Yu-Chun Lin1,2, Yon-Cheong Wong1,2,3
1Department of Medical Imaging and Intervention, Linkou Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Gueishan, Taoyuan 33305, Taiwan.
Background:
The International Society of Urological Pathology (ISUP) grade and positive surgical margins (PSMs) after radical prostatectomy (RP) may reflect the prognosis of prostate cancer (PCa) patients. This study aimed to investigate whether DCE-MRI parameters (i.e., K, k, and IAUC) could predict ISUP grade and PSMs after RP.
Method:
Forty-five PCa patients underwent preoperative DCE-MRI. The clinical characteristics and DCE-MRI parameters of the 45 patients were compared between the low- and high-risk (i.e., ISUP grades III-V) groups and between patients with or without PSMs after RP. Multivariate logistic regression analysis was used to identify the significant predictors of placement in the high-risk group and PSMs.
Results:
The DCE parameter K was significantly higher in the high-risk group than in the low-risk group (p = 0.028) and was also a significant predictor of placement in the high-risk group (odds ratio [OR] = 1.032, 95% confidence interval [CI] = 1.005-1.060, p = 0.021). Patients with PSMs had significantly higher prostate-specific antigen (PSA) titers, positive biopsy core percentages, K, k, and k than others (all p < 0.05). Of these, positive biopsy core percentage (OR = 1.035, 95% CI = 1.003-1.068, p = 0.032) and kx (OR = 1.078, 95% CI = 1.012-1.148, p = 0.020) were significant predictors of PSMs.
Conclusion:
Preoperative DCE-MRI parameters, specifically K and k could potentially serve as preoperative imaging biomarkers for postoperative PCa prognosis based on their predictability of PCa risk group and PSM on RP, respectively.
Insights
Dynamic contrast-enhanced MRI (DCE-MRI) parameters like K and k can predict prostate cancer (PCa) risk and positive surgical margins (PSMs) after radical prostatectomy (RP), aiding in preoperative prognosis assessment.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Prognosis for prostate cancer (PCa) patients after radical prostatectomy (RP) is influenced by International Society of Urological Pathology (ISUP) grade and positive surgical margins (PSMs).
- Accurate preoperative prediction of these factors is crucial for patient management.
Purpose of the Study:
- To evaluate the predictive capability of dynamic contrast-enhanced MRI (DCE-MRI) parameters, specifically K, k, and IAUC, for ISUP grade and PSMs in PCa patients undergoing RP.
Main Methods:
- Forty-five PCa patients underwent preoperative DCE-MRI.
- Clinical data and DCE-MRI parameters were compared between low-risk (ISUP grades I-II) and high-risk (ISUP grades III-V) groups, and between patients with and without PSMs.
- Multivariate logistic regression identified significant predictors for high-risk group and PSMs.
Main Results:
- The DCE parameter K was significantly higher in the high-risk group (p=0.028) and predicted high-risk status (OR=1.032).
- Patients with PSMs exhibited higher PSA titers, positive biopsy core percentages, K, k, and k values (all p<0.05).
- Positive biopsy core percentage (OR=1.035) and k (OR=1.078) significantly predicted PSMs.
Conclusions:
- Preoperative DCE-MRI parameters K and k show potential as imaging biomarkers.
- These parameters can predict PCa risk group and PSMs, respectively, aiding in postoperative prognosis assessment after RP.
