scholarly journals MRI grading for the prediction of prostate cancer aggressiveness

2021 ◽  
Author(s):  
M. Boschheidgen ◽  
L. Schimmöller ◽  
C. Arsov ◽  
F. Ziayee ◽  
J. Morawitz ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Treatment Planning ◽  
Clinical Pathway ◽  
B Value ◽  
Low Grade ◽  
Grade Group ◽  
Adc Value ◽  
High B Value ◽  
Cancer Aggressiveness ◽  
Grade Groups

Abstract Objectives T o evaluate the value of multiparametric MRI (mpMRI) for the prediction of prostate cancer (PCA) aggressiveness. Methods In this single center cohort study, consecutive patients with histologically confirmed PCA were retrospectively enrolled. Four different ISUP grade groups (1, 2, 3, 4–5) were defined and fifty patients per group were included. Several clinical (age, PSA, PSAD, percentage of PCA infiltration) and mpMRI parameters (ADC value, signal increase on high b-value images, diameter, extraprostatic extension [EPE], cross-zonal growth) were evaluated and correlated within the four groups. Based on combined descriptors, MRI grading groups (mG1–mG3) were defined to predict PCA aggressiveness. Results In total, 200 patients (mean age 68 years, median PSA value 8.1 ng/ml) were analyzed. Between the four groups, statistically significant differences could be shown for age, PSA, PSAD, and for MRI parameters cross-zonal growth, high b-value signal increase, EPE, and ADC (p < 0.01). All examined parameters revealed a significant correlation with the histopathologic biopsy ISUP grade groups (p < 0.01), except PCA diameter (p = 0.09). A mixed linear model demonstrated the strongest prediction of the respective ISUP grade group for the MRI grading system (p < 0.01) compared to single parameters. Conclusions MpMRI yields relevant pre-biopsy information about PCA aggressiveness. A combination of quantitative and qualitative parameters (MRI grading groups) provided the best prediction of the biopsy ISUP grade group and may improve clinical pathway and treatment planning, adding useful information beyond PI-RADS assessment category. Due to the high prevalence of higher grade PCA in patients within mG3, an early re-biopsy seems indicated in cases of negative or post-biopsy low-grade PCA. Key Points • MpMRI yields relevant pre-biopsy information about prostate cancer aggressiveness. • MRI grading in addition to PI-RADS classification seems to be helpful for a size independent early prediction of clinically significant PCA. • MRI grading groups may help urologists in clinical pathway and treatment planning, especially when to consider an early re-biopsy.

scholarly journals Utility of T2-weighted MRI texture analysis in assessment of peripheral zone prostate cancer aggressiveness: a single-arm, multicenter study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Gabriel A. Nketiah ◽  
◽  
Mattijs Elschot ◽  
Tom W. Scheenen ◽  
Marnix C. Maas ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Texture Analysis ◽  
Multicenter Study ◽  
Peripheral Zone ◽  
Support Vector ◽  
Low Grade ◽  
Textural Features ◽  
Grade Group ◽  
Cancer Aggressiveness ◽  
Grade Groups

AbstractT2-weighted (T2W) MRI provides high spatial resolution and tissue-specific contrast, but it is predominantly used for qualitative evaluation of prostate anatomy and anomalies. This retrospective multicenter study evaluated the potential of T2W image-derived textural features for quantitative assessment of peripheral zone prostate cancer (PCa) aggressiveness. A standardized preoperative multiparametric MRI was performed on 87 PCa patients across 6 institutions. T2W intensity and apparent diffusion coefficient (ADC) histogram, and T2W textural features were computed from tumor volumes annotated based on whole-mount histology. Spearman correlations were used to evaluate association between textural features and PCa grade groups (i.e. 1–5). Feature utility in differentiating and classifying low-(grade group 1) vs. intermediate/high-(grade group ≥ 2) aggressive cancers was evaluated using Mann–Whitney U-tests, and a support vector machine classifier employing “hold-one-institution-out” cross-validation scheme, respectively. Textural features indicating image homogeneity and disorder/complexity correlated significantly (p < 0.05) with PCa grade groups. In the intermediate/high-aggressive cancers, textural homogeneity and disorder/complexity were significantly lower and higher, respectively, compared to the low-aggressive cancers. The mean classification accuracy across the centers was highest for the combined ADC and T2W intensity-textural features (84%) compared to ADC histogram (75%), T2W histogram (72%), T2W textural (72%) features alone or T2W histogram and texture (77%), T2W and ADC histogram (79%) combined. Texture analysis of T2W images provides quantitative information or features that are associated with peripheral zone PCa aggressiveness and can augment their classification.

scholarly journals Family history of prostate cancer and prostate tumor aggressiveness in black and non-black men;results from an equal access biopsy study

2021 ◽  
Author(s):  
Kimberly R. Jenkins ◽  
Taofik Oyekunle ◽  
Lauren E. Howard ◽  
Emily K. Wiggins ◽  
Stephen J. Freedland ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Family History ◽  
Black Men ◽  
Prostate Biopsy ◽  
Equal Access ◽  
Low Grade ◽  
High Grade ◽  
Tumor Aggressiveness ◽  
Grade Group ◽  
Cancer Aggressiveness

Abstract Purpose To test for racial differences in associations between family history (FH) of prostate cancer (PC) and prostate cancer aggressiveness in a racially diverse equal access population undergoing prostate biopsy. Subjects/patients and methods We prospectively enrolled men undergoing prostate biopsy at the Durham Veterans Administration from 2007 to 2018 and assigned case or control status based on biopsy results. Race and FH of PC were self-reported on questionnaires. Logistic regression was used to test the association between FH and PC diagnosis overall and by tumor aggressiveness [high- (Grade Group 3–5) or low-grade (Grade Group 1–2) vs. no cancer], overall, and stratified by race. Models were adjusted for age and year of consent, race, PSA level, digital rectal exam findings, prostate volume, and previous (negative) biopsy receipt. Results Of 1,225 men, 323 had a FH of PC and 652 men were diagnosed with PC on biopsy. On multivariable analysis, FH was associated with increased odds of high-grade PC in black (OR 1.85, p = 0.041) and all men (OR 1.56, p = 0.057) and was unrelated to overall or low-grade PC diagnosis, overall, or stratified by race (all p ≥ 0.325). In sensitivity analyses among men without a previous biopsy, results were slightly more pronounced. Conclusion In this setting of equal access to care, positive FH of PC was associated with increased tumor aggressiveness in black men, but not non-black men undergoing prostate biopsy. Further research is required to tease apart the contribution of genetics from increased PC awareness potentially influencing screening and biopsy rates in men with FH.

scholarly journals The Primacy of High B-Value 3T-DWI Radiomics in the Prediction of Clinically Significant Prostate Cancer

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 739
Author(s):  
Alessandro Bevilacqua ◽  
Margherita Mottola ◽  
Fabio Ferroni ◽  
Alice Rossi ◽  
Giampaolo Gavelli ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Quantitative Imaging ◽  
B Value ◽  
Support Vector ◽  
Svm Classifier ◽  
Primary Role ◽  
High B Value ◽  
Wilcoxon Rank Sum Test ◽  
Apparent Diffusion ◽  
Clinically Significant

Predicting clinically significant prostate cancer (csPCa) is crucial in PCa management. 3T-magnetic resonance (MR) systems may have a novel role in quantitative imaging and early csPCa prediction, accordingly. In this study, we develop a radiomic model for predicting csPCa based solely on native b2000 diffusion weighted imaging (DWIb2000) and debate the effectiveness of apparent diffusion coefficient (ADC) in the same task. In total, 105 patients were retrospectively enrolled between January–November 2020, with confirmed csPCa or ncsPCa based on biopsy. DWIb2000 and ADC images acquired with a 3T-MRI were analyzed by computing 84 local first-order radiomic features (RFs). Two predictive models were built based on DWIb2000 and ADC, separately. Relevant RFs were selected through LASSO, a support vector machine (SVM) classifier was trained using repeated 3-fold cross validation (CV) and validated on a holdout set. The SVM models rely on a single couple of uncorrelated RFs (ρ < 0.15) selected through Wilcoxon rank-sum test (p ≤ 0.05) with Holm–Bonferroni correction. On the holdout set, while the ADC model yielded AUC = 0.76 (95% CI, 0.63–0.96), the DWIb2000 model reached AUC = 0.84 (95% CI, 0.63–0.90), with specificity = 75%, sensitivity = 90%, and informedness = 0.65. This study establishes the primary role of 3T-DWIb2000 in PCa quantitative analyses, whilst ADC can remain the leading sequence for detection.

scholarly journals Potential synergy between PSMA uptake and tumour blood flow for prediction of human prostate cancer aggressiveness

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mads Ryø Jochumsen ◽  
Jens Sörensen ◽  
Lars Poulsen Tolbod ◽  
Bodil Ginnerup Pedersen ◽  
Jørgen Frøkiær ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Blood Flow ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Standardized Uptake Value ◽  
Tumour Blood Flow ◽  
Combined Model ◽  
Grade Group ◽  
Cancer Aggressiveness ◽  
Tumour Blood

Abstract Background Both prostate-specific membrane antigen (PSMA) uptake and tumour blood flow (TBF) correlate with International Society of Urological Pathology (ISUP) Grade Group (GG) and hence prostate cancer (PCa) aggressiveness. The aim of the present study was to evaluate the potential synergistic benefit of combining the two physiologic parameters for separating significant PCa from insignificant findings. Methods From previous studies of [82Rb]Rb positron emission tomography (PET) TBF in PCa, the 43 patients that underwent clinical [68Ga]Ga-PSMA-11 PET were selected for this retrospective study. Tumours were delineated on [68Ga]Ga-PSMA-11 PET or magnetic resonance imaging. ISUP GG was recorded from 52 lesions. Results [68Ga]Ga-PSMA-11 maximum standardized uptake value (SUVmax) and [82Rb]Rb SUVmax correlated moderately with ISUP GG (rho = 0.59 and rho = 0.56, both p < 0.001) and with each other (r = 0.65, p < 0.001). A combined model of [68Ga]Ga-PSMA-11 and [82Rb]Rb SUVmax separated ISUP GG > 2 from ISUP GG 1–2 and benign with an area-under-the-curve of 0.85, 96% sensitivity, 74% specificity, and 95% negative predictive value. The combined model performed significantly better than either tracer alone did (p < 0.001), primarily by reducing false negatives from five or six to one (p ≤ 0.025). Conclusion PSMA uptake and TBF provide complementary information about tumour aggressiveness. We suggest that a combined analysis of PSMA uptake and TBF could significantly improve the negative predictive value and allow non-invasive separation of significant from insignificant PCa.

Clinical impact of ultra-high b-value (3000 s/mm2) diffusion-weighted magnetic resonance imaging in prostate cancer at 3T: comparison with b-value of 2000 s/mm2

2021 ◽  
pp. 20210465
Author(s):  
Tsutomu Tamada ◽  
Ayumu Kido ◽  
Yu Ueda ◽  
Mitsuru Takeuchi ◽  
Takeshi Fukunaga ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Performance ◽  
Signal To Noise Ratio ◽  
B Value ◽  
Single Shot ◽  
Signal To Noise ◽  
High B Value ◽  
Diffusion Weighted ◽  
Significant Difference ◽  
Noise Ratio

Objective: High b-value diffusion-weighted imaging (hDWI) with a b-value of 2000 s/mm2 provides insufficient image contrast between benign and malignant tissues and an overlap of apparent diffusion coefficient (ADC) between Gleason grades (GG) in prostate cancer (PC). We compared image quality, PC detectability, and discrimination ability for PC aggressiveness between ultra-high b-value DWI (uhDWI) of 3000 s/mm2 and hDWI. Methods: The subjects were 49 patients with PC who underwent 3T multiparametric MRI. Single-shot echo-planar DWI was acquired with b-values of 0, 2000, and 3000 s/mm2. Anatomical distortion of prostate (AD), signal intensity of benign prostate (PSI), and lesion conspicuity score (LCS) were assessed using a 4-point scale; and signal-to-noise ratio, contrast-to-noise ratio, and mean ADC (×10–3 mm2/s) of lesion (lADC) and surrounding benign region (bADC) were measured. Results: PSI was significantly lower in uhDWI than in hDWI (p < 0.001). AD, LCS, signal-to-noise ratio, and contrast-to-noise ratio were comparable between uhDWI and hDWI (all p > 0.05). In contrast, lADC was significantly lower than bADC in both uhDWI and hDWI (both p < 0.001). In comparison of lADC between tumors of ≤GG2 and those of ≥GG3, both uhDWI and hDWI showed significant difference (p = 0.007 and p = 0.021, respectively). AUC for separating tumors of ≤GG2 from those of ≥GG3 was 0.731 in hDWI and 0.699 in uhDWI (p = 0.161). Conclusion: uhDWI suppressed background signal better than hDWI, but did not contribute to increased diagnostic performance in PC. Advances in knowledge: Compared with hDWI, uhDWI could not contribute to increased diagnostic performance in PC.

Image quality and diagnostic accuracy of complex-averaged high b value images in diffusion-weighted MRI of prostate cancer

2019 ◽  
Vol 44 (6) ◽  
pp. 2244-2253 ◽  
Author(s):  
Hamed Kordbacheh ◽  
Ravi Teja Seethamraju ◽  
Elisabeth Weiland ◽  
Berthold Kiefer ◽  
Marcel Dominik Nickel ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Image Quality ◽  
Diagnostic Accuracy ◽  
B Value ◽  
Diffusion Weighted Mri ◽  
High B Value ◽  
Diffusion Weighted

Among men with low-grade prostate cancer on prostate biopsy, the 4Kscore to predict prostate cancer aggressiveness at prostatectomy.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 65-65
Author(s):  
Bruno Nahar ◽  
Sanoj Punnen ◽  
Stephen M Zappala ◽  
Daniel Sjoberg ◽  
Dipen Parekh
Keyword(s):  
Prostate Cancer ◽  
United States ◽  
Radical Prostatectomy ◽  
Prostate Biopsy ◽  
The United States ◽  
Low Grade ◽  
Surgical Specimen ◽  
Aggressive Prostate Cancer ◽  
Free Psa ◽  
Cancer Aggressiveness

65 Background: Most men diagnosed with prostate cancer in the United States have low-grade tumors. While many of these men are good candidates for active surveillance, a proportion will have a bad outcome due to the presence of a more aggressive prostate cancer that was missed on initial biopsy. A recent study confirmed the 4Kscore accurately predicts the likelihood of aggressive cancer on prostate biopsy. We analyzed if the 4Kscore could predict the presence of more significant cancer in men with low-grade tumors on the diagnostic biopsy. Methods: A recent prospective validation of the 4Kscore was conducted at 26 sites throughout the United States. We selected men who were found to have low-grade (Gleason 6) cancer on biopsy for this analysis. The 4Kscore calculates the risk of aggressive prostate cancer on prostate biopsy by a blood test that measures levels of four kallikrein biomarkers (total PSA, free PSA, intact PSA, and human kallikrein-2) plus age, DRE findings, and prior biopsy status. We investigated whether the 4Kscore was associated with more significant cancer among men found to have Gleason 6 cancer on prostate biopsy. We also looked at a subset of these men who underwent radical prostatectomy to see if the 4Kscore was associated with prostate cancer being upgraded in the surgical specimen. Results: Among the 1,312 men enrolled in this trial, 306 men were found to have Gleason 6 cancer on prostate biopsy. The 4Kscore was significantly associated with the number of positive cores (p=0.001) and the millimeters of cancer seen (p=0.0002), with higher 4Kscores relating to more extensive cancer present on biopsy. In the subpopulation of 51 men who underwent radical prostatectomy, the median 4Kscore was significantly higher among men who had an upgrade to Gleason 7 or higher [15% (8,25)] compared to men who did not experience an upgrade [7% (4,14)] (p=0.032) in their final pathology. Conclusions: Among men with Gleason 6 prostate cancer on biopsy, the 4Kscore was associated with the prostate cancer being upgraded in the surgical specimen at radical prostatectomy. The 4Kscore test may facilitate the selection of men who can be observed versus those who should undergo immediate treatment.

scholarly journals The diagnostic accuracy of high b-value diffusion- and T2-weighted imaging for the detection of prostate cancer: a meta-analysis

2017 ◽  
Vol 43 (7) ◽  
pp. 1787-1797 ◽  
Author(s):  
Tom J. Syer ◽  
Keith C. Godley ◽  
Donnie Cameron ◽  
Paul N. Malcolm
Keyword(s):  
Prostate Cancer ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
B Value ◽  
High B Value
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