Stephan H Polanec1, Katja Pinker-Domenig1, Peter Brader1, Dietmar Georg2,3, Shahrokh Shariat4, Claudio Spick1, Martin Susani5, Thomas H Helbich6, Pascal A Baltzer7. 1. Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria. 2. Division of Medical Radiation Physics, Department of Radiation Oncology, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria. 3. Christian Doppler Laboratory for Medical Radiation Research for Radiation Oncology, Medical University Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria. 4. Department of Urology, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria. 5. Clinical Institute of Pathology, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria. 6. Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria. thomas.helbich@meduniwien.ac.at. 7. Division of Molecular and Gender Imaging, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna (AKH), Waehringer-Guertel 18-20, 1090, Vienna, Austria. pascal.baltzer@meduniwien.ac.at.
Abstract
PURPOSE: The aim of our study was to assess whether multiparametric magnetic resonance imaging (MP-MRI) of the prostate with three parameters (PS3: T2-weighted, DWI, and DCE) benefits from an additional fourth parameter (PS4: including (1)H-MRSI) in the detection and grading of prostate cancer (PCa) at 3 T. METHODS: MP-MRI was performed in 64 patients (mean 66.7 years, mean PSA 13 ng/ml). Reference standard was obtained by histopathology. Two readers independently evaluated the images. A summation score of each individual parameter for three parameters (PS3) and for four parameters (PS4) was calculated. RESULTS: In 52 (81.3 %) of 64 patients, histopathology confirmed a PCa. The diagnostic performance for PCa detection of PS4 (O1: 91.7 %, O2: 91.3 %) equaled that of PS3 (O1: 92.8 %, O2: 92.2 %, P > 0.05). Prediction of high-grade PCa by PS4 (O1: 75.1 %, O2: 74.7 %) was as good as with PS3 (O1: 75.1 %, O2: 72.8 %, P > 0.05). Kappa agreement between the two readers was substantial (0.734 PS4) to moderate (0.558 PS3). CONCLUSIONS: MP-MRI with four parameters including (1)H-MRSI does not increase the detection and grading of prostate cancer at 3 T compared to MP-MRI with three parameters. A sum score accurately detects PCa at 3 T without an endorectal coil and shows potential for the prediction of tumor grade.
PURPOSE: The aim of our study was to assess whether multiparametric magnetic resonance imaging (MP-MRI) of the prostate with three parameters (PS3: T2-weighted, DWI, and DCE) benefits from an additional fourth parameter (PS4: including (1)H-MRSI) in the detection and grading of prostate cancer (PCa) at 3 T. METHODS: MP-MRI was performed in 64 patients (mean 66.7 years, mean PSA 13 ng/ml). Reference standard was obtained by histopathology. Two readers independently evaluated the images. A summation score of each individual parameter for three parameters (PS3) and for four parameters (PS4) was calculated. RESULTS: In 52 (81.3 %) of 64 patients, histopathology confirmed a PCa. The diagnostic performance for PCa detection of PS4 (O1: 91.7 %, O2: 91.3 %) equaled that of PS3 (O1: 92.8 %, O2: 92.2 %, P > 0.05). Prediction of high-grade PCa by PS4 (O1: 75.1 %, O2: 74.7 %) was as good as with PS3 (O1: 75.1 %, O2: 72.8 %, P > 0.05). Kappa agreement between the two readers was substantial (0.734 PS4) to moderate (0.558 PS3). CONCLUSIONS: MP-MRI with four parameters including (1)H-MRSI does not increase the detection and grading of prostate cancer at 3 T compared to MP-MRI with three parameters. A sum score accurately detects PCa at 3 T without an endorectal coil and shows potential for the prediction of tumor grade.
Entities:
Keywords:
1H-MRSI; Grading; Multiparametric MRI; PI-RADS; Prostate cancer; Sum score
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