Roberto Sanz-Requena1, Luis Martí-Bonmatí2, Rosario Pérez-Martínez3, Gracián García-Martí4. 1. Biomedical Engineering, Hospital Quirónsalud Valencia, Valencia, Spain; Radiology Department, Hospital Quirónsalud Valencia, Valencia, Spain; GIBI230, Instituto de Investigación Sanitaria y Hospital Universitari i Politècnic La Fe, Valencia, Spain. Electronic address: roberto.sanz@quironsalud.es. 2. Radiology Department, Hospital Quirónsalud Valencia, Valencia, Spain; GIBI230, Instituto de Investigación Sanitaria y Hospital Universitari i Politècnic La Fe, Valencia, Spain. 3. Radiology Department, Hospital Quirónsalud Valencia, Valencia, Spain. 4. Biomedical Engineering, Hospital Quirónsalud Valencia, Valencia, Spain; Radiology Department, Hospital Quirónsalud Valencia, Valencia, Spain; GIBI230, Instituto de Investigación Sanitaria y Hospital Universitari i Politècnic La Fe, Valencia, Spain; CIBER-SAM, Instituto de Salud Carlos III, Madrid, Spain.
Abstract
PURPOSE: The aim of this work is to establish normality and tumor tissue ranges for perfusion parameters from dynamic contrast-enhanced (DCE) MR of the peripheral prostate at 3T and to compare the diagnostic performance of quantitative and semi-quantitative parameters. MATERIALS AND METHODS: Thirty-six patients with prostate carcinomas (18 Gleason-6, 15 Gleason-7, and 3 Gleason-8) and 33 healthy subjects were included. Image analysis workflow comprised four steps: manual segmentation of whole prostate and lesions, series registration, voxelwise T1 mapping and calculation of pharmacokinetic and semi-quantitative parameters. RESULTS: Ktrans, ve, upslope and AUC60 showed statistically significant differences between healthy peripheral areas and tumors. Curve type showed no association with healthy/tumor peripheral areas (chi-square=0.702). Areas under the ROC curves were 0.64 (95% CI: 0.54-0.75), 0.70 (0.60-0.80), 0.62 (0.51-0.72) and 0.63 (0.52-0.74) for Ktrans, ve, upslope and AUC60, respectively. The optimal cutoff values were: Ktrans=0.21min-1 (sensitivity=0.61, specificity=0.64), ve=0.36 (0.63, 0.71), upslope=0.59 (0.59, 0.59) and AUC60=2.4 (0.63, 0.64). Significant differences were found between Gleason scores 6 and 7 for normalized Ktrans, upslope and AUC60, with good diagnostic accuracy (area under ROC curve 0.80, 95% CI: 0.60-1.00). CONCLUSION: Quantitative (Ktrans and ve) and semi-quantitative (upslope and AUC60) perfusion parameters showed significant differences between tumors and control areas in the peripheral prostate. Normalized Ktrans, upslope and AUC60 values might characterize tumor aggressiveness.
PURPOSE: The aim of this work is to establish normality and tumor tissue ranges for perfusion parameters from dynamic contrast-enhanced (DCE) MR of the peripheral prostate at 3T and to compare the diagnostic performance of quantitative and semi-quantitative parameters. MATERIALS AND METHODS: Thirty-six patients with prostate carcinomas (18 Gleason-6, 15 Gleason-7, and 3 Gleason-8) and 33 healthy subjects were included. Image analysis workflow comprised four steps: manual segmentation of whole prostate and lesions, series registration, voxelwise T1 mapping and calculation of pharmacokinetic and semi-quantitative parameters. RESULTS:Ktrans, ve, upslope and AUC60 showed statistically significant differences between healthy peripheral areas and tumors. Curve type showed no association with healthy/tumor peripheral areas (chi-square=0.702). Areas under the ROC curves were 0.64 (95% CI: 0.54-0.75), 0.70 (0.60-0.80), 0.62 (0.51-0.72) and 0.63 (0.52-0.74) for Ktrans, ve, upslope and AUC60, respectively. The optimal cutoff values were: Ktrans=0.21min-1 (sensitivity=0.61, specificity=0.64), ve=0.36 (0.63, 0.71), upslope=0.59 (0.59, 0.59) and AUC60=2.4 (0.63, 0.64). Significant differences were found between Gleason scores 6 and 7 for normalized Ktrans, upslope and AUC60, with good diagnostic accuracy (area under ROC curve 0.80, 95% CI: 0.60-1.00). CONCLUSION: Quantitative (Ktrans and ve) and semi-quantitative (upslope and AUC60) perfusion parameters showed significant differences between tumors and control areas in the peripheral prostate. Normalized Ktrans, upslope and AUC60 values might characterize tumor aggressiveness.
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