Enhancement patterns of prostate cancer in dynamic MRI

Abstract

Our objective was to analyze fast-field-echo dynamic subtracted (FFE/DS) MRI data in prostate cancer, in order to recognize enhancement patterns of tumoral tissue in comparison with non-tumoral peripheral prostatic tissue. Eleven consecutive patients with prostate cancer were proposed for radical prostatectomy. Before surgery, all patients underwent endorectal coil MRI examination. In addition to standard sequences, a dynamic study was performed by FFE/DS to evaluate tumoral behavior after Gd-DTPA rapid infusion. Analysis of the imaging was made by the means of the time/signal intensity curve obtained during early contrast medium enhancement, sampling both the abnormal enhancing focal area and the opposite lobe at the level of the main prostatic tissue. A focal area of increased enhancement was observed in the site of the tumor in all cases.The time/intensity curve sampled on this area and compared with the opposite lobe demonstrated a high confidence interval of the difference of the data: mean tumor maximal intensity 1331 (SD 187) vs normal 470 (SD 139) and mean tumor rise time 103 s (SD 30) vs normal 250 (SD 38; p<0.01). In tumoral tissue, the enhancement percentage of signal intensity (SI%=pre-contrast minus post-contrast/pre-contrast ×100) was 316.7%. At FFE/DS, there is a typical behavior of the time/intensity curve of contrast enhancement in prostatic cancer that might be employed in diagnosis of the disease.

Prostate cancer detection with 3 T MRI: Comparison of diffusion‐weighted imaging and dynamic contrast‐enhanced MRI in combination with T2‐weighted imaging

“…Prostate cancer tends to show early enhancement and late washout due to hypervascularity. Although several authors have reported good diagnostic accuracy for 1.5 T MRI using quantitative analyses based on the time‐intensity curve or the tracer kinetic model (29, 30), Girouin et al (10) reported that the use of simple visual diagnostic criteria also gives reasonable results at 1.5 T MRI. We used simple visual diagnostic criteria for DCEI in our series.…”

Prostate cancer screening: The clinical value of diffusion‐weighted imaging and dynamic MR imaging in combination with T2‐weighted imaging

“…In particular, the optimum imaging period after gadolinium injection remains unknown; moreover, thus far, there is limited information on the time‐enhancement curves of prostate cancer and the normal surrounding tissues (32–33). Recently, quantitative analyses using the time‐intensity curve or the tracer kinetic model have been reported (10, 34, 35). Preziosi et al (34) reported that the time period between the bolus injection and the maximum intensity in cancerous tissue ranged 70–180 seconds (mean = 103 seconds), whereas that in noncancerous tissue ranged 200–300 seconds (mean = 250 seconds).…”

“…Recently, quantitative analyses using the time‐intensity curve or the tracer kinetic model have been reported (10, 34, 35). Preziosi et al (34) reported that the time period between the bolus injection and the maximum intensity in cancerous tissue ranged 70–180 seconds (mean = 103 seconds), whereas that in noncancerous tissue ranged 200–300 seconds (mean = 250 seconds). In our protocol, the scan time of dynamic MRI was 22 seconds and the delay time was 40–180 seconds, which seemed to be a reasonable imaging window to enable peak enhancement of cancer.…”

Multidimensional MR spectroscopic imaging of prostate cancer in vivo

“…A number of studies have reported an increased microvessel density (MVD) in PCa, potentially enabling the detection or localization of tumors through imaging techniques sensitive to these characteristics . DCE‐MRI of PCa is often found to enhance more quickly, to a greater degree, and to show more washout than the benign PZ . Malignant tissue differs from benign tissue with respect to microvessel density, blood flow, vascular morphology and permeability, and flow dynamics .…”