308 MAGNETIC RESONANCE IMAGING FOR NONINVASIVE PREDICTION OF PATHOLOGIC GLEASON SCORE

Abstract

You have accessJournal of UrologyProstate Cancer: Staging II1 Apr 2010308 MAGNETIC RESONANCE IMAGING FOR NONINVASIVE PREDICTION OF PATHOLOGIC GLEASON SCORE Nicholas Buchan, Piotr Kozlowski, Silvia Chang, Edward Jones, Ran Meng, and Larry Goldenberg Nicholas BuchanNicholas Buchan More articles by this author , Piotr KozlowskiPiotr Kozlowski More articles by this author , Silvia ChangSilvia Chang More articles by this author , Edward JonesEdward Jones More articles by this author , Ran MengRan Meng More articles by this author , and Larry GoldenbergLarry Goldenberg More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.371AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To test whether Diffusion and Dynamic Contrast Enhanced MRI can predict final Gleason score in radical prostatectomy specimens. METHODS Twenty seven patients with a high clinical suspicion for prostate cancer (elevated serum prostate-specific antigen (PSA) and/or prostate nodule detected during digital rectal examination) underwent Diffusion Tensor Imaging (DTI) and Dynamic Contrast Enhanced (DCE) MRI examination at 3.0 T prior to biopsy. Average values of the average diffusivity <D>, fractional anisotropy FA, volume transfer constant Ktrans, fractional volume of extra-vascular extra-cellular space ve, and fractional volume of blood plasma vp were calculated from the tumours and correlated with Gleason score obtained from both the biopsy and prostatectomy specimen. RESULTS Average values of <D> and FA for the Gleason score 3+3 were significantly higher than for the scores 3+4 (p < 0.05), 4+3 (p < 0.01), and 4+5 (p < 0.01). In addition, the average values of <D> and FA for the score 4+3 were significantly higher than for the score 4+5 (p < 0.05). Average value of ve for the score 3+4 was significantly different than for the score 4+5 (p < 0.001), and the average value of vp for the score 4+5 was significantly lower than for the scores 3+3 (p < 0.05) and 3+4 (p < 0.01). There was significant correlation between Gleason score and <D> (rho = -0.661, p = 0.0005), FA (rho = - 0.551, p = 0.0036) and vp (rho = -0.423, p = 0.0251). Ordinal logistic regression modelling showed statistically significant dependence between the Gleason score and the MRI parameters (p < 0.0001 for the model), however only <D> and FA significantly contributed to the model (p = 0.018 for <D> and p = 0.009 for FA). CONCLUSIONS Both average diffusivity <D> and fractional anisotropy FA correlate strongly with Gleason score. These results suggest that DTI MRI is capable of non-invasively grading prostate tumours. This finding needs further evaluation and validation, but suggests great potential for the selection and monitoring of active surveillence and focal therapy patients. Table 1. Average Values (mean +/- SD) of DTI and DCE MRI parameters Gleason Score <D>[10-3mm2/sec] FA Ktrans[min-1] Ve Vp 3+3 (n=7) 1.30+/- 0.15 a,b,c 0.25+/- 0.04e,b,c 0.15+/- 0.10 0.21+/- 0.08 0.013+/- 0.010 g 3+4 (n=13) 1.09+/- 0.18 0.19+/- 0.04 0.16+/- 0.07 0.22+/- 0.02 f 0.006+/- 0.006h 4+3 (n=6) 1.05+/- 0.03d 0.20+/- 0.04d 0.12+/- 0.05 0.18+/- 0.04 0.006+/- 0.005 4+5 (n=3) 0.98+/- 0.04 0.13+/- 0.02 0.14+/- 0.01 0.15+/- 0.01 0.0005+/- 0.0005 a 3+3 different that 3+4 (p < 0.05), b 3+3 different than 4+3 (p < 0.01), c 3+3 different than 4+5 (p < 0.01), d 4+3 different than 4+5 (p < 0.05), e 3+3 different than 3+4 (p < 0.01), f 3+4 different than 4+5 (p < 0.001), g 3+3 different than 4+5 (p < 0.05), h 3+4 different than 4+5 (p < 0.01) Vancouver, Canada© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e122 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Nicholas Buchan More articles by this author Piotr Kozlowski More articles by this author Silvia Chang More articles by this author Edward Jones More articles by this author Ran Meng More articles by this author Larry Goldenberg More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...