Is There an Added Value of Quantitative DCE-MRI by Magnetic Resonance Dispersion Imaging for Prostate Cancer Diagnosis?

Affiliations
  • 1Department of Urology, Amsterdam UMC, University of Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
  • 2Department of Electrical Engineering, Eindhoven University of Technology, 5612 AP Eindhoven, The Netherlands.
  • 3Leiden University Medical Center, Department of Urology, 2333 ZA Leiden, The Netherlands.
  • 4Department of Radiology and Nuclear Imaging, Maastricht University Medical Centre+, 6229 HX Maastricht, The Netherlands.
  • 5Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands.
  • 6Department of Radiology, Netherlands Cancer Institute, 1066 CX Amsterdam, The Netherlands.
  • 7Department of Pathology, Jeroen Bosch Hospital, 5223 GZ ‘s-Hertogenbosch, The Netherlands.
  • 8Department of Radiology, Radboud University Nijmegen Medical Center, 6525 GA Nijmegenfi, The Netherlands.

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Abstract

In this multicenter, retrospective study, we evaluated the added value of magnetic resonance dispersion imaging (MRDI) to standard multiparametric MRI (mpMRI) for PCa detection. The study included 76 patients, including 51 with clinically significant prostate cancer (csPCa), who underwent radical prostatectomy and had an mpMRI including dynamic contrast-enhanced MRI. Two radiologists performed three separate randomized scorings based on mpMRI, MRDI and mpMRI+MRDI. Radical prostatectomy histopathology was used as the reference standard. Imaging and histopathology were both scored according to the Prostate Imaging-Reporting and Data System V2.0 sector map. Sensitivity and specificity for PCa detection were evaluated for mpMRI, MRDI and mpMRI+MRDI. Inter- and intra-observer variability for both radiologists was evaluated using Cohen’s Kappa. On a per-patient level, sensitivity for csPCa for radiologist 1 (R1) for mpMRI, MRDI and mpMRI+MRDI was 0.94, 0.82 and 0.94, respectively. For the second radiologist (R2), these were 0.78, 0.94 and 0.96. R1 detected 4% additional csPCa cases using MRDI compared to mpMRI, and R2 detected 20% extra csPCa cases using MRDI. Inter-observer agreement was significant only for MRDI (Cohen’s Kappa = 0.4250, = 0.004). The results of this study show the potential of MRDI to improve inter-observer variability and the detection of csPCa.