Dynamic Contrast Enhanced MRI of the Prostate: Comparison of Gadobutrol and Gd-DTPA

Abstract

Purpose: To evaluate the enhancement profile of the macrocyclic contrast medium (CM) gadobutrol in comparison to linear CM Gd-DTPA in DCE-MRI of the prostate. Materials and Methods: In total 53 patients with prostata cancer (PCa) were included, who received a radical prostatectomy after multiparametric MRI of the prostate including DCE-MRI. Using circular regions of interests normal peripheral zone (PZ) and PCa foci >?5?mm in diameter (42 and 34 foci in Gd-DTPA and gadobutrol group, respectively) were analysed in DCE-MRI. Enhancement curves (Type I, II and III) and pharmacokinetic parameters were analyzed qualitatively and quantitatively and compared using mixed linear models (two sided p-values <?0.05 were regarded significant). Results: There was no significant difference in frequencies of curve types I, II or III in the normal PZ (p?=?0.63) or in PCa foci (p?=?0.75). PCa with a Gleason score ??7 had in comparison to Gleason ??6 significantly more often a Wash-Out-curve (Type III) with both CM (p?=?0.02). The relative peak enhancement was in the PZ (Gd-DTPA 1.4 a.?u. [1.20; 1.59], gadobutrol 1.58 a.?u. [1.37; 1.78]) and in PCa foci (Gd-DTPA 1.56 a.?u. [1.41; 1.71], gadobutrol 1.76 a.?u. [1.59; 1.94]) significantly higher with gadobutrol (p?=?0.04). The pharmacokinetic parameters Ktrans und kep were higher in PCa foci than in PZ (p?<?0.0001 and p?=?0.002, respectively) without significant difference of the parameter values between both CM (p?=?0.65). Conlusion: This study is the first systematic comparison of gadobutrol and Gd-DTPA in DCE-MRI of the prostate. The relative peak enhancement is higher using gadobutrol compared to Gd-DTPA in DCE-MRI. There was no statistically significant difference in curve types or the pharmacokinetic parameters in PCa or normal PZ between both CM. Key Points: Citation Format:

Application of multivariate image analysis to prostate cancer for improving the comprehension of the related physiological phenomena and the development and validation of new imaging biomarkers

“…This way, the mean fscore raised up to 0.7857 with 0.8145 as its maximum value, heavily reducing the rate of false positives (from 15.4% to 7.4%), which corresponds with 0.74 of sensitivity and 0.85 of specificity. These results are better than other studies including only first generation pharmacokinetic models [92,[119][120][121][122]. Additionally, no statistically significant differences were observed between the MCR and combined models.…”

Multiparametric Magnetic Resonance Imaging in the Detection of Prostate Cancer

“…Contrast-enhanced MRI sequences can be used to assess the vascularity and permeability of tissues. Gadolinium-containing extracellular T1w contrast agent is typically administered intravenously for this purpose [22]. Fast T1w gradient echo sequences with a temporal resolution of 4 -10 seconds are primarily used in prostate imaging.…”

“…Prostate cancers are characterized by fast wash-in (early peak enhancement) and fast wash-out compared to healthy tissue (type III curve). Enhancement typically increases steadily (type I) in the given measurement time in cancer-free tissue, while a curve with a plateau (type II) occurs relatively frequently both in healthy tissue and in cancer tissue [22]. On the basis of enhancement curves, gadolinium concentrations in tissue and tissue transport constants in the direction of the tumor interstitium (K trans ) and back in the direction of the blood plasma (k ep ) can be calculated using suitable mathematical models (two-compartment Tofts model).…”

Prostate Cancer Detection with Multiparametric MRI: A Comparison of 1 M-Concentration Gadobutrol with 0.5 M-Concentration Gadolinium-Based Contrast Agents

“…A previous report on prostate MRI which compared 1 M gadobutrol with 0.5 M concentrations of other GBCAs found no significant differences among the enhancement profiles. The authors did note, however, that gadobutrol yielded higher and faster peak enhancement in prostate cancer and in the normal peripheral zone than gadolinium dieth-ylenetriamine pentaacetic acid [19]. However, the ability to accurately detect prostate cancer in multiparametric MRI using 1 M gadobutrol is unknown.…”