Sessiz ve anlamlı prostat kanseri ayrımında kantitatif DCE-MRG faydalı mıdır?

Year 2020, , 1186 - 1189, 01.12.2020

Mehmet Coskun , Merve Horoz

https://doi.org/10.28982/josam.840971

Abstract

Amaç: Prostat manyetik rezonans görüntülemede (MRG) dinamik kontrastlı inceleme (DKİ) için direk görsel değerlendirme önerilir. Kalitatif bir yaklaşım olarak bu okuyucular arası uyumsuzluğa neden olur. Bu çalışmada, tüm-spesimen histopatolojisini referans kabul ederek sessiz ve anlamlı prostat kanserlerinde kantitatif DKİ parametrelerinin karşılaştırılması amaçlanmıştır.
Yöntemler: Multiparametrik MRG ve ardından radikal prostatektomi yapılan 76 olgu çalışmaya dahil edildi. İndeks tümörün yeri patoloji raporu kullanılarak tespit edildi. Bu bölgenin MRG bulguları başka bir radyolog tarafından prostat görüntüleme-raporlama ve bilgi sistemi versiyon 2.1 (PI-RADSv2.1) kullanılarak incelendi. Gleason 3+3 tümörler sessiz, Gleason ≥ 3+4 tümörler anlamlı kanser kabul edildi. İlgi alanı (ROI), lezyona ve normal periferal zona yerleştirildi. Ktrans, Kep, Ve, başlangıç eğrisinin altındaki alan (EAA) için lezyon değeri ve lezyon/normal oranı hesaplandı. Bu parametreler T testi kullanılarak sessiz ve anlamlı kanserlerde karşılaştırıldı.
Bulgular: Olguların PI-RADSv2.1 skoru 2’den 5’e olgu sayısı sırasıyla 5, 4, 24 ve 43’tü. Sessiz kanserli olgu sayısı 13, anlamlı kanserli olgu sayısı 63 idi. Ktrans, Kep, Ve, EAA lezyon/normal oranları sessiz kanserler için sırasıyla 1.6, 1.59, 12, 2.1 iken, anlamlı kanserler için 3.1, 4.04, 1.39, 2.8 idi. Ktrans lezyon/normal oranı anlamlı kanserlerde yüksek iken, Ve lezyon/normal oranı sessiz kanserlerde yüksekti. Kep ve EAA için sessiz ve anlamlı kanserlerde anlamlı fark yoktu (P>0,05).
Sonuç: Kantitatif değerlendirme, dinamik MRG’de daha objektif-kopyalanabilir sonuçlar sunar. Ktrans ve Ve lezyon/normal doku oranları, sessiz ve anlamlı kanserin ayrımında yardımcıdır.

Keywords

Dinamik MRG, Gleason, multiparametrik prostat MRG, perfüzyon MRG, prostat kanseri

Supporting Institution

yok

Project Number

yok

Is quantitative DCE-MRI useful in differentiation of indolent and significant prostate cancers?

Abstract

Aim: Direct visual assessment is recommended in prostate magnetic resonance imaging (MRI) for dynamic contrast enhancement (DCE), however, being a qualitative approach, it may cause inter-reader variability. The purpose of this study was to compare quantitative DCE parameters in the differentiation of clinically significant prostate cancer from indolent cancer using whole-mount histopathology.
Methods: Seventy-six patients who underwent multiparametric MRI with suspicion of prostate cancer and subsequent radical prostatectomy were included. Index tumor location was determined with pathology reports. MRI findings of this location were evaluated by a different radiologist using prostate imaging-reporting and data system version 2.1 (PI-RADSv2.1) guideline. Gleason 3+3 tumors were considered indolent, and Gleason ≥ 3+4 tumors were considered significant cancers. Region-of-interests (ROI) were placed in the lesion and the normal peripheral zone. Lesion values and lesion/normal ratios of Ktrans, Kep, Ve, area under curve (iAUC) were calculated. T test was used in statistical analysis.
Results: The numbers of cases with PI-RADSv2.1 scores of 2, 3, 4 and 5 were 5, 4, 24, and 43, respectively. There were 13 indolent cases and 63 patients with significant prostate cancer. Lesion/normal ratios of Ktrans, Kep, Ve, iAUC were 1.6, 1.59, 12, 2.1, respectively, in indolent cancers, and 3.1, 4.04, 1.39, 2.8, respectively, in significant cancers. Lesion/normal ratio of Ktrans was higher in significant cancers while lesion/normal ratio of Ve was higher in indolent cancers. Kep and iAUC were similar (P>0.05 for each).
Conclusion: Quantitative DCE assessment may demonstrate more reproducible results. Lesion/normal tissue ratios of Ktrans and Ve were helpful in differentiation between indolent and significant prostate cancers.

Keywords

dynamic mri, gleason, multiparametric prostate mri, perfusion mri, prostate cancer

Project Number

yok

References

• 1. American Cancer Society. Key Statistics for Prostate Cancer, 2020. [Internet]. https://www.cancer.org/cancer/prostate-cancer/about/key-statistics.html. Accessed on 01 Nov 2020.
• 2. Roobol MJ, Kranse R, Bangma CH, van Leenders AG, Blijenberg BG, van Schaik RH, et al. Screening for prostate cancer: results of the Rotterdam section of the European randomized study of screening for prostate cancer. Eur Urol. 2013;64(4):530-9. Epub 2013/06/14. doi: 10.1016/j.eururo.2013.05.030. PubMed PMID: 23759326.
• 3. Oberlin DT, Casalino DD, Miller FH, Meeks JJ. Dramatic increase in the utilization of multiparametric magnetic resonance imaging for detection and management of prostate cancer. Abdom Radiol (NY). 2017;42(4):1255-8. Epub 2016/11/20. doi: 10.1007/s00261-016-0975-5. PubMed PMID: 27858090.
• 4. Turkbey B, Rosenkrantz AB, Haider MA, Padhani AR, Villeirs G, Macura KJ, et al. Prostate Imaging Reporting and Data System Version 2.1: 2019 Update of Prostate Imaging Reporting and Data System Version 2. Eur Urol. 2019;76(3):340-51. Epub 2019/03/23. doi: 10.1016/j.eururo.2019.02.033. PubMed PMID: 30898406.
• 5. Woo S, Suh CH, Kim SY, Cho JY, Kim SH, Moon MH. Head-to-Head Comparison Between Biparametric and Multiparametric MRI for the Diagnosis of Prostate Cancer: A Systematic Review and Meta-Analysis. AJR Am J Roentgenol. 2018;211(5):W226-w41. Epub 2018/09/22. doi: 10.2214/ajr.18.19880. PubMed PMID: 30240296.
• 6. Alabousi M, Salameh JP, Gusenbauer K, Samoilov L, Jafri A, Yu H, et al. Biparametric vs multiparametric prostate magnetic resonance imaging for the detection of prostate cancer in treatment-naïve patients: a diagnostic test accuracy systematic review and meta-analysis. BJU Int. 2019;124(2):209-20. Epub 2019/04/01. doi: 10.1111/bju.14759. PubMed PMID: 30929292.
• 7. Smith CP, Harmon SA, Barrett T, Bittencourt LK, Law YM, Shebel H, et al. Intra- and interreader reproducibility of PI-RADSv2: A multireader study. J Magn Reson Imaging. 2019;49(6):1694-703. Epub 2018/12/24. doi: 10.1002/jmri.26555. PubMed PMID: 30575184; PubMed Central PMCID: PMCPMC6504619.
• 8. Rosenkrantz AB, Babb JS, Taneja SS, Ream JM. Proposed Adjustments to PI-RADS Version 2 Decision Rules: Impact on Prostate Cancer Detection. Radiology. 2017;283(1):119-29. Epub 2016/10/27. doi: 10.1148/radiol.2016161124. PubMed PMID: 27783538.
• 9. Tofts PS, Brix G, Buckley DL, Evelhoch JL, Henderson E, Knopp MV, et al. Estimating kinetic parameters from dynamic contrast-enhanced T(1)-weighted MRI of a diffusable tracer: standardized quantities and symbols. J Magn Reson Imaging. 1999;10(3):223-32. Epub 1999/10/03. doi: 10.1002/(sici)1522-2586(199909)10:3<223::aid-jmri2>3.0.co;2-s. PubMed PMID: 10508281.
• 10. Nicholson B, Schaefer G, Theodorescu D. Angiogenesis in prostate cancer: biology and therapeutic opportunities. Cancer Metastasis Rev. 2001;20(3-4):297-319. Epub 2002/06/28. doi: 10.1023/a:1015543713485. PubMed PMID: 12085968.
• 11. Verma S, Turkbey B, Muradyan N, Rajesh A, Cornud F, Haider MA, et al. Overview of dynamic contrast-enhanced MRI in prostate cancer diagnosis and management. AJR Am J Roentgenol. 2012;198(6):1277-88. Epub 2012/05/25. doi: 10.2214/ajr.12.8510. PubMed PMID: 22623539; PubMed Central PMCID: PMCPMC6309691.
• 12. Tofts PS, Wicks DA, Barker GJ. The MRI measurement of NMR and physiological parameters in tissue to study disease process. Prog Clin Biol Res. 1991;363:313-25. Epub 1991/01/01. PubMed PMID: 1988983.
• 13. Lee HS, Kim SH, Kang BJ, Baek JE, Song BJ. Perfusion Parameters in Dynamic Contrast-enhanced MRI and Apparent Diffusion Coefficient Value in Diffusion-weighted MRI:: Association with Prognostic Factors in Breast Cancer. Acad Radiol. 2016;23(4):446-56. Epub 2016/02/08. doi: 10.1016/j.acra.2015.12.011. PubMed PMID: 26852247.
• 14. Awasthi R, Pandey CM, Sahoo P, Behari S, Kumar V, Kumar S, et al. Dynamic contrast-enhanced magnetic resonance imaging-derived kep as a potential biomarker of matrix metalloproteinase 9 expression in patients with glioblastoma multiforme: a pilot study. J Comput Assist Tomogr. 2012;36(1):125-30. Epub 2012/01/21. doi: 10.1097/RCT.0b013e31823f6c59. PubMed PMID: 22261782.
• 15. Nguyen TB, Cron GO, Mercier JF, Foottit C, Torres CH, Chakraborty S, et al. Preoperative prognostic value of dynamic contrast-enhanced MRI-derived contrast transfer coefficient and plasma volume in patients with cerebral gliomas. AJNR Am J Neuroradiol. 2015;36(1):63-9. Epub 2014/06/21. doi: 10.3174/ajnr.A4006. PubMed PMID: 24948500.
• 16. Choi YS, Kim DW, Lee SK, Chang JH, Kang SG, Kim EH, et al. The Added Prognostic Value of Preoperative Dynamic Contrast-Enhanced MRI Histogram Analysis in Patients with Glioblastoma: Analysis of Overall and Progression-Free Survival. AJNR Am J Neuroradiol. 2015;36(12):2235-41. Epub 2015/09/05. doi: 10.3174/ajnr.A4449. PubMed PMID: 26338911.
• 17. Turkbey B, Pinto PA, Mani H, Bernardo M, Pang Y, McKinney YL, et al. Prostate cancer: value of multiparametric MR imaging at 3 T for detection--histopathologic correlation. Radiology. 2010;255(1):89-99. Epub 2010/03/24. doi: 10.1148/radiol.09090475. PubMed PMID: 20308447; PubMed Central PMCID: PMCPMC2843833.
• 18. Fütterer JJ, Heijmink SW, Scheenen TW, Veltman J, Huisman HJ, Vos P, et al. Prostate cancer localization with dynamic contrast-enhanced MR imaging and proton MR spectroscopic imaging. Radiology. 2006;241(2):449-58. Epub 2006/09/13. doi: 10.1148/radiol.2412051866. PubMed PMID: 16966484.
• 19. Moradi M, Salcudean SE, Chang SD, Jones EC, Buchan N, Casey RG, et al. Multiparametric MRI maps for detection and grading of dominant prostate tumors. J Magn Reson Imaging. 2012;35(6):1403-13. Epub 2012/01/24. doi: 10.1002/jmri.23540. PubMed PMID: 22267089; PubMed Central PMCID: PMCPMC5478377.
• 20. Vos EK, Litjens GJ, Kobus T, Hambrock T, Hulsbergen-van de Kaa CA, Barentsz JO, et al. Assessment of prostate cancer aggressiveness using dynamic contrast-enhanced magnetic resonance imaging at 3 T. Eur Urol. 2013;64(3):448-55. Epub 2013/06/12. doi: 10.1016/j.eururo.2013.05.045. PubMed PMID: 23751135.
• 21. Wei C, Jin B, Szewczyk-Bieda M, Gandy S, Lang S, Zhang Y, et al. Quantitative parameters in dynamic contrast-enhanced magnetic resonance imaging for the detection and characterization of prostate cancer. Oncotarget. 2018;9(22):15997-6007. Epub 2018/04/18. doi: 10.18632/oncotarget.24652. PubMed PMID: 29662622; PubMed Central PMCID: PMCPMC5882313.
• 22. Weinreb JC, Barentsz JO, Choyke PL, Cornud F, Haider MA, Macura KJ, et al. PI-RADS Prostate Imaging - Reporting and Data System: 2015, Version 2. Eur Urol. 2016;69(1):16-40. Epub 2015/10/03. doi: 10.1016/j.eururo.2015.08.052. PubMed PMID: 26427566; PubMed Central PMCID: PMCPMC6467207.
• 23. 23. Rosenkrantz AB, Geppert C, Grimm R, Block TK, Glielmi C, Feng L, et al. Dynamic contrast-enhanced MRI of the prostate with high spatiotemporal resolution using compressed sensing, parallel imaging, and continuous golden-angle radial sampling: preliminary experience. J Magn Reson Imaging. 2015;41(5):1365-73. Epub 2014/05/17. doi: 10.1002/jmri.24661. PubMed PMID: 24833417; PubMed Central PMCID: PMCPMC4233205.