Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) is a useful modality for the precise detection and staging of early prostate cancer

Abstract

DCE-MRI can identify early stage Cap with high sensitivity and specificity, and can predict the histological grade to some extent. DCE-MRI prior to biopsy should be applied to younger patients with surgical indications. Otherwise, we recommend the definitive diagnosis of Cap by utilizing DCE-MRI alone.

Prostate cancer detection using an extended prostate biopsy schema in combination with additional targeted cores from suspicious images in conventional and functional endorectal magnetic resonance imaging of the prostate

“…Yuen et al 27 exhibited a sensitivity and specificity of 82.1 and 100%, with a PCa detection rate of 29.2%. Hara et al 28 using dce-MRI achieved a sensitivity of 93% and a specificity of 96% in a group of 90 patients. PCa detection was 36.8%.…”

DCE and DW MRI in monitoring response to androgen deprivation therapy in patients with prostate cancer: A feasibility study

“…There have been two prior studies on quantitative DCE MRI of prostate cancer before and after ADT (17,19), and one study investigating semiquantitative DCE MRI combined with MR spectroscopy (20), however none of these studies incorporated DW MRI. DCE MRI has been validated as a surrogate marker of tumor angiogenesis in prostate cancer and other primary tumors (21,22). In murine models, androgen ablation has been shown to suppress the production of the angiogenic factor VEGF (vascular endothelial growth factor) by the glandular epithelium and induce apoptosis of endothelial cells (23,24).…”

The predictability of T3 disease in staging MRI following prostate biopsy decreases in patients with high initial PSA and Gleason score

“…With a Gleason score cutoff of 7.5, the sensitivity was 83.3%, and the specificity was 52.6%. When applying clinical cutoffs of initial PSA of 10 and 20 ng ml 21 , the accuracy of MRI in the prediction of ECE was significantly decreased in the group with PSA over 20 ng ml 21 (75.6%, 64.5% and 37.5%, P50.01 by Chi-square test, Table 6), and this group also had significantly decreased accuracy of MRI in the prediction of SVI (91.5%, 77.4% and 37.5%, P,0.01; Table 7). Applying the clinical cutoff of a Gleason score of 7, the accuracy of MRI in prediction of SVI was significantly decreased in the higher Gleason score group (93.9%, 82.1% and 62.9%, P50.01).…”

“…While a clinically acceptable cutoff was not determined, the AUC in ROC using initial PSA was 0.652 in the prediction of ECE and 0.771 in the prediction of SVI. Using the clinical cutoffs of PSA 10 and 20 ng ml 21 and a Gleason score of 7 points, accuracy decreased significantly in the high PSA and Gleason score groups. These observations imply that for patients with PSA over 20 ng ml 21 or Gleason score over 7 points, the presence of ECE or SVI in specific sites on the prostate cannot be reliably predicted with only preoperative MRI findings that were conducted after prostate biopsy.…”

“…To overcome the artefacts mainly induced by post-biopsy haemorrhage, some researchers suggested conducting MRI before prostate biopsy. Using DCE-MRI, Hara et al 21 demonstrated a sensitivity of 93% and a specificity of 96% in 90 men with elevated PSA who had MRI before prostate biopsy. However, voxels suspicious of malignancy were demonstrated in 44 patients, with only 11 of these having cancer on biopsy, hence leading to a specificity of 54% and an accuracy of 60%.…”