Visibility of significant prostate cancer on multiparametric magnetic resonance imaging (MRI)-do we still need contrast media?

Autor: Huebner NA; Department of Urology, Medical University of Vienna, Vienna, Austria.; Working Group for Diagnostic imaging in Urology (ABDU), Austrian association of Urology (ÖGU), Vienna, Austria., Korn S; Department of Urology, Medical University of Vienna, Vienna, Austria., Resch I; Department of Urology, Medical University of Vienna, Vienna, Austria., Grubmüller B; Department of Urology, Medical University of Vienna, Vienna, Austria., Gross T; Department of Urology, Medical University of Vienna, Vienna, Austria., Gale R; Department of Urology, Medical University of Vienna, Vienna, Austria., Kramer G; Department of Urology, Medical University of Vienna, Vienna, Austria., Poetsch N; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20 1090, Vienna, Austria., Clauser P; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20 1090, Vienna, Austria., Haitel A; Department of Pathology, Medical University of Vienna, Vienna, Austria., Fajkovic H; Department of Urology, Medical University of Vienna, Vienna, Austria.; Working Group for Diagnostic imaging in Urology (ABDU), Austrian association of Urology (ÖGU), Vienna, Austria.; Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria., Shariat SF; Department of Urology, Medical University of Vienna, Vienna, Austria.; Division of Urology, Department of Urology, University of Jordan, Amman, Jordan.; Institute of Urology and Reproductive Health, Sechenov University, Moscow, Russia.; Department of Urology, Weill Cornell Medical Centre, New York, USA.; Department of Urology, University of Texas Southwestern, Dallas, USA., Baltzer PA; Working Group for Diagnostic imaging in Urology (ABDU), Austrian association of Urology (ÖGU), Vienna, Austria. Pascal.baltzer@meduniwien.ac.at.; Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Währinger Gürtel 18-20 1090, Vienna, Austria. Pascal.baltzer@meduniwien.ac.at.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2021 Jun; Vol. 31 (6), pp. 3754-3764. Date of Electronic Publication: 2020 Dec 02.
DOI: 10.1007/s00330-020-07494-1
Abstrakt: Objectives: To assess the visibility of clinically significant prostate cancer (PCA) lesions on the sequences multiparametric MRI of the prostate (mpMRI) and to evaluate whether the addition of dynamic contrast-enhanced imaging (DCE) improves the overall visibility.
Methods: We retrospectively evaluated multiparametric MRI images of 119 lesions in 111 patients with biopsy-proven clinically significant PCA. Three readers assigned visual grading scores for visibility on each sequence, and a visual grading characteristic analysis was performed. Linear regression was used to explore which factors contributed to visibility in individual sequences.
Results: The visibility of lesions was significantly better with mpMRI when compared to biparametric MRI in visual grading characteristic (VGC) analysis, with an AUC VGC of 0.62 (95% CI 0.55-0.69; p < 0.001). This benefit was seen across all readers. Multivariable linear regression revealed that a location in the peripheral zone was associated with better visibility on T2-weighted imaging (T2w). A higher Prostate Imaging-Reporting and Data System (PI-RADS) score was associated with better visibility on both diffusion-weighted imaging (DWI) and DCE. Increased lesion size was associated with better visibility on all sequences.
Conclusions: Visibility of clinically significant PCA is improved by using mpMRI. DCE and DWI images independently improve lesion visibility compared to T2w images alone. Further research into the potential of DCE to impact on clinical decision-making is suggested.
Key Points: • DCE and DWI images independently improve clinically significant prostate cancer lesion visibility compared to T2w images alone. • Multiparametric MRI (DCE, DWI, T2w) achieved significantly higher visibility scores than biparametric MRI (DWI, T2w). • Location in the transition zone is associated with poor visibility on T2w, while it did not affect visibility on DWI or DCE.
Databáze: MEDLINE
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