scholarly journals Impact of qualitative, semi-quantitative, and quantitative analyses of dynamic contrast-enhanced magnet resonance imaging on prostate cancer detection

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249532
Author(s):  
Farid Ziayee ◽  
Tim Ullrich ◽  
Dirk Blondin ◽  
Hannes Irmer ◽  
Christian Arsov ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Cancer Detection ◽  
Area Under The Curve ◽  
Assessment Method ◽  
Resonance Imaging ◽  
Benign Lesions ◽  
Magnet Resonance Imaging ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
Magnet Resonance

Dynamic contrast enhanced imaging (DCE) as an integral part of multiparametric prostate magnet resonance imaging (mpMRI) can be evaluated using qualitative, semi-quantitative, or quantitative assessment methods. Aim of this study is to analyze the clinical benefits of these evaluations of DCE regarding clinically significant prostate cancer (csPCa) detection and grading. 209 DCE data sets of 103 consecutive patients with mpMRI (T2, DWI, and DCE) and subsequent MRI-(in-bore)-biopsy were retrospectively analyzed. Qualitative DCE evaluation according to PI-RADS v2.1, semi-quantitative (curve type; DCE score according to PI-RADS v1), and quantitative Tofts analyses (Ktrans, kep, and ve) as well as PI-RADS v1 and v2.1 overall classification of 209 lesions (92 PCa, 117 benign lesions) were performed. Of each DCE assessment method, cancer detection, discrimination of csPCa, and localization were assessed and compared to histopathology findings. All DCE analyses (p<0.01–0.05), except ve (p = 0.02), showed significantly different results for PCa and benign lesions in the peripheral zone (PZ) with area under the curve (AUC) values of up to 0.92 for PI-RADS v2.1 overall classification. In the transition zone (TZ) only the qualitative DCE evalulation within PI-RADS (v1 and v2.1) could distinguish between PCa and benign lesions (p<0.01; AUC = 0.95). None of the DCE parameters could differentiate csPCa from non-significant (ns) PCa (p ≥ 0.1). Qualitative analysis of DCE within mpMRI according to PI-RADS version 2.1 showed excellent results regarding (cs)PCa detection. Semi-quantitative and quantitative parameters provided no additional improvements. DCE alone wasn’t able to discriminate csPCa from nsPCa.

Diagnostic performance of diffusion-weighted imaging combined with dynamic contrast-enhanced magnetic resonance imaging for prostate cancer: a systematic review and meta-analysis

2020 ◽  
pp. 028418512095626
Author(s):  
Lu Yang ◽  
Yuchuan Tan ◽  
Hanli Dan ◽  
Lin Hu ◽  
Jiuquan Zhang
Keyword(s):  
Magnetic Resonance Imaging ◽  
Prostate Cancer ◽  
Magnetic Resonance ◽  
Likelihood Ratio ◽  
Diffusion Weighted Imaging ◽  
Diagnostic Performance ◽  
Resonance Imaging ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced

Background The diagnostic performance of diffusion-weighted imaging (DWI) combined with dynamic contrast-enhanced (DCE)-magnetic resonance imaging (MRI) for the detection of prostate cancer (PCa) has not been studied systematically to date. Purpose To investigate the value of DWI combined with DCE-MRI quantitative analysis in the diagnosis of PCa. Material and Methods A systematic search was conducted through PubMed, MEDLINE, the Cochrane Library, and EMBASE databases without any restriction to language up to 10 December 2019. Studies that used a combination of DWI and DCE-MRI for diagnosing PCa were included. Results Nine studies with 778 participants were included. The combination of DWI and DCE-MRI provide accurate performance in diagnosing PCa with pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratios of 0.79 (95% confidence interval [CI] = 0.76–0.81), 0.85 (95% CI = 0.83–0.86), 6.58 (95% CI = 3.93–11.00), 0.24 (95% CI = 0.17–0.34), and 36.43 (95% CI = 14.41–92.12), respectively. The pooled area under the summary receiver operating characteristic curve was 0.9268. Moreover, 1.5-T MR scanners demonstrated a slightly better performance than 3.0-T scanners. Conclusion Combined DCE-MRI and DWI could demonstrate a highly accurate area under the curve, sensitivity, and specificity for detecting PCa. More studies with large sample sizes are warranted to confirm these results.

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