DCE-MRI of the prostate using shutter-speed vs. Tofts model for tumor characterization and assessment of aggressiveness

Stefanie J Hectors; Cecilia Besa; Mathilde Wagner; Guido H Jajamovich; George K Haines 3rd; Sara Lewis; Ashutosh Tewari; Ardeshir Rastinehad; Wei Huang; Bachir Taouli

doi:10.1002/jmri.25631

DCE-MRI of the prostate using shutter-speed vs. Tofts model for tumor characterization and assessment of aggressiveness

J Magn Reson Imaging. 2017 Sep;46(3):837-849. doi: 10.1002/jmri.25631. Epub 2017 Jan 16.

Authors

Stefanie J Hectors¹, Cecilia Besa^{1

2}, Mathilde Wagner¹, Guido H Jajamovich³, George K Haines 3rd⁴, Sara Lewis^{1

2}, Ashutosh Tewari⁵, Ardeshir Rastinehad⁵, Wei Huang⁶, Bachir Taouli^{1

2}

Affiliations

¹ Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
² Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
³ Applied Mathematics and Modeling, Scientific Informatics Department, Merck Sharp & Dohme, Boston, Massachusetts, USA.
⁴ Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁵ Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
⁶ Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA.

PMID: 28092414
DOI: 10.1002/jmri.25631

Abstract

Purpose: To quantify Tofts model (TM) and shutter-speed model (SSM) perfusion parameters in prostate cancer (PCa) and noncancerous peripheral zone (PZ) and to compare the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to Prostate Imaging and Reporting and Data System (PI-RADS) classification for the assessment of PCa aggressiveness.

Materials and methods: Fifty PCa patients (mean age 60 years old) who underwent MRI at 3.0T followed by prostatectomy were included in this Institutional Review Board-approved retrospective study. DCE-MRI parameters (K^trans , v_e , k_ep [TM&SSM] and intracellular water molecule lifetime τ_i [SSM]) were determined in PCa and PZ. Differences in DCE-MRI parameters between PCa and PZ, and between models were assessed using Wilcoxon signed-rank tests. Receiver operating characteristic (ROC) analysis for differentiation between PCa and PZ was performed for individual and combined DCE-MRI parameters. Diagnostic performance of DCE-MRI parameters for identification of aggressive PCa (Gleason ≥8, grade group [GG] ≥3 or pathology stage pT3) was assessed using ROC analysis and compared with PI-RADSv2 scores.

Results: DCE-MRI parameters were significantly different between TM and SSM and between PZ and PCa (P < 0.037). Diagnostic performances of TM and SSM for differentiation of PCa from PZ were similar (highest AUC TM: K^trans +k_ep 0.76, SSM: τ_i +k_ep 0.80). PI-RADS outperformed TM and SSM DCE-MRI for identification of Gleason ≥8 lesions (AUC PI-RADS: 0.91, highest AUC DCE-MRI: K^trans +τ_i SSM 0.61, P = 0.002). The diagnostic performance of PI-RADS and DCE-MRI for identification of GG ≥3 and pT3 PCa was not significantly different (P > 0.213).

Conclusion: SSM DCE-MRI did not increase the diagnostic performance of DCE-MRI for PCa characterization. PI-RADS outperformed both TM and SSM DCE-MRI for identification of aggressive cancer.

Level of evidence: 3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:837-849.

Keywords: DCE-MRI; Tofts; prostate cancer; shutter-speed.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Contrast Media*
Humans
Image Enhancement / methods*
Image Processing, Computer-Assisted / methods*
Magnetic Resonance Imaging / methods*
Male
Middle Aged
Neoplasm Invasiveness
Prostate / diagnostic imaging
Prostate / pathology
Prostatic Neoplasms / diagnostic imaging*
Prostatic Neoplasms / pathology*
Reproducibility of Results
Retrospective Studies

Substances

Contrast Media

Grants and funding

U01 CA154602/CA/NCI NIH HHS/United States