Quantitative Multi-Parametric MRI of the Prostate Reveals Racial Differences.

Area of Science:

• Radiology and Imaging Science
• Oncology and Cancer Research
• Medical Diagnostics

Background:

• Prostate cancer (PCa) diagnosis and management can be influenced by racial differences.
• Quantitative magnetic resonance imaging (qMRI) metrics may reveal underlying biological variations.
• Understanding race-specific differences in PCa imaging is crucial for accurate diagnosis.

Purpose of the Study:

• To investigate racial disparities in quantitative MRI and prostate histology between African Americans (AAs) and Caucasian Americans (CAs).
• To determine if these differences impact the diagnostic accuracy of MRI for prostate cancer.

Main Methods:

• 3T MRI (T2W, DWI, DCE-MRI) was performed on 98 CAs and 47 AAs with suspected PCa.
• Quantitative MRI metrics (ADC, T2, DCE parameters α and β) were calculated.
• Histologic analysis of prostatectomy specimens was conducted.

Main Results:

• AAs had a higher percentage of higher Gleason-grade PCa.
• No significant differences in ADC or T2 values were observed between groups.
• DCE-MRI showed significantly higher enhancement rate (α) in AAs (13.3 s⁻¹) vs. CAs (6.1 s⁻¹).
• DCE-MRI washout rate (β) differed significantly in both benign (lower in AAs) and cancer tissue (higher in AAs).
• DCE-MRI improved PCa differentiation in AAs (α: 52%, β: 62% more effective).
• Histology revealed AAs had lower epithelial proportion and higher lumen in PCa compared to CAs.

Conclusions:

• African Americans exhibit distinct quantitative DCE-MRI values and PCa histology compared to Caucasian Americans.
• Quantitative DCE-MRI significantly enhances prostate cancer detection in AAs.
• MRI performance for PCa diagnosis is race-dependent, with DCE-MRI being more effective in AAs.