Habitats in DCE-MRI to Predict Clinically Significant Prostate Cancers

Nestor Andres Parra,Julio Pow-Sang,Robert J Gillies,Yoganand Balagurunathan,Jung Choi,Kenneth Gage,Hong Lu

doi:10.18383/j.tom.2018.00037

Nestor Andres Parra, Julio Pow-Sang + Show 5 more

Open Access

https://doi.org/10.18383/j.tom.2018.00037

Copy DOI

Abstract

Prostate cancer identification and assessment of clinical significance continues to be a challenge. Routine multiparametric magnetic resonance imaging has shown to be useful in assessing disease progression. Although dynamic contrast-enhanced imaging (DCE) has the ability to characterize perfusion across time and has shown enormous utility, radiological assessment (Prostate Imaging-Reporting and Data System or PIRADS version 2) has limited its use owing to lack of consistency and nonquantitative nature. In our work, we propose a systematic methodology to quantify perfusion dynamics for the DCE imaging. Using these metrics, 7 different subregions or perfusion habitats of the targeted lesions are localized and related to clinical significance. We found that quantitative features describing the habitat based on the late area under the DCE time-activity curve was a good predictor of clinical significance disease. The best predictive feature in the habitat had an AUC of 0.82, CI [0.81–0.83].

Highlights

Prostate cancer is the second leading cause of cancer deaths among men in the United States and accounts to be the third largest among newly diagnosed cancer cases (19%) [1]
Rising prostatic-specific antigen and abnormal digital-rectal examination have been traditionally used in the diagnosis of prostate cancer
Advancements in image acquisition and resolution of multiparametric magnetic resonance imaging (mpMRI) coupled with the use of fusion-based transrectal ultrasonography (TRUS)– guided biopsy has improved disease detection and shown promise in improving diagnosis and treatment [5]

Summary

Introduction

Prostate cancer is the second leading cause of cancer deaths among men in the United States and accounts to be the third largest among newly diagnosed cancer cases (19%) [1]. Rising prostatic-specific antigen and abnormal digital-rectal examination have been traditionally used in the diagnosis of prostate cancer. The United States Preventive Services Task Force (USPSTF) has recommended against the routine use of prostatic-specific antigen testing for diagnosis of prostate cancer, owing to the risk of overdiagnosis and overtreatment [3, 4]. Advancements in image acquisition and resolution of mpMRI coupled with the use of fusion-based transrectal ultrasonography (TRUS)– guided biopsy has improved disease detection and shown promise in improving diagnosis and treatment [5]. Routine MP-MRI includes T2-weighted (T2W) imaging that describes the prostate anatomy, diffusion-weighted imaging (DWI) that measures the density of cellular space by quantifying the diffusion of water molecules. DCE image data shows the dynamics of the administered contrast agent, which characterizes the blood flow into prostate tissue and allows the identification of suspicious lesions by localizing abnormal contrast absorption

Methods

Results

Discussion

Conclusion