Related Experiment Video
Updated: Jun 4, 2025
A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
Differentiating clinically significant prostate cancer from clinically insignificant prostate cancer using
Tsutomu Tamada1, Mitsuru Takeuchi2,3, Hiroyuki Watanabe2
1Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan. ttamada@med.kawasaki-m.ac.jp.
Purpose:
To investigate the utility of qualitative and semi-quantitative evaluation of DCE-MRI for detecting clinically significant prostate cancer (csPC).
Methods:
This retrospective study analyzed 307 lesions in 231 patients who underwent 3.0T MRI. Experienced radiologists assessed PI-RADS v 2.1 assessment category, qualitative contrast enhancement (QCE), contrast enhancement pattern (CEP: type 1, 2, 3), tumor contrast ratio, and tumor size of PC lesions in consensus. Mean and 0-10th-percentile ADC value of the lesion (ADCmean and ADC0-10) were calculated. Specimens obtained from MRI-ultrasound fusion-guided prostate biopsy were used as the pathological reference standard.
Results:
In assessment of tumor aggressiveness, PI-RADS assessment category, QCE, tumor size, and ratio of CEP 2 + 3 were significantly higher in PC with Gleason score (GS) ≥ 3 + 4 (n = 256) than in PC with GS = 6 (n = 51) (P ≤ 0.001). Tumor ADCmean and tumor ADC0-10 were comparable between PC with GS ≥ 3 + 4 and PC with GS = 6 (P = 0.164 to 0.504). Regarding diagnostic performance of csPC in 45 PI-RADS 3 transition zone lesions, only ratio of CEP 2 + 3 was significantly higher in PC with GS ≥ 3 + 4 (n = 31) than in PC with GS = 6 (n = 14) (P = 0.008).
Conclusion:
Qualitative DCE-MRI indices may contribute to PC aggressiveness and improve detection of csPC in PI-RADS assessment category 3 lesions.
