Multi‐parametric (mp) MRI of prostatic ductal adenocarcinoma

Coffey, Niamh; Schieda, Nicola; Cron, Greg O.; Gulavita, Previn; Kien, T.; Flood, Trevor A.

doi:10.1002/jmri.24694

Cited by 23 publications

(16 citation statements)

References 33 publications

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“…Wibner et al [21] have previously demonstrated the utility of ADC-derived textural parameters in TZ tumour detection and differentiating grade based on lesion analysis. The textural analysis approach may obviate previously described efforts to normalise by using ADC ratios (normalized to non-tumorous tissues) [22], perform whole lesion measurement and/or generate histogram analysis including median and low percentile ADC values [23]. …”

Section: Discussionmentioning

confidence: 99%

“Textural analysis of multiparametric MRI detects transition zone prostate cancer”

et al. 2016

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ObjectivesTo evaluate multiparametric-MRI (mpMRI) derived histogram textural-analysis parameters for detection of transition zone (TZ) prostatic tumour.MethodsSixty-seven consecutive men with suspected prostate cancer underwent 1.5T mpMRI prior to template-mapping-biopsy (TPM). Twenty-six men had ‘significant’ TZ tumour. Two radiologists in consensus matched TPM to the single axial slice best depicting tumour, or largest TZ diameter for those with benign histology, to define single-slice whole TZ-regions-of-interest (ROIs). Textural-parameter differences between single-slice whole TZ-ROI containing significant tumour versus benign/insignificant tumour were analysed using Mann Whitney U test. Diagnostic accuracy was assessed by receiver operating characteristic area under curve (ROC-AUC) analysis cross-validated with leave-one-out (LOO) analysis.ResultsADC kurtosis was significantly lower (p < 0.001) in TZ containing significant tumour with ROC-AUC 0.80 (LOO-AUC 0.78); the difference became non-significant following exclusion of significant tumour from single-slice whole TZ-ROI (p = 0.23). T1-entropy was significantly lower (p = 0.004) in TZ containing significant tumour with ROC-AUC 0.70 (LOO-AUC 0.66) and was unaffected by excluding significant tumour from TZ-ROI (p = 0.004). Combining these parameters yielded ROC-AUC 0.86 (LOO-AUC 0.83).ConclusionTextural features of the whole prostate TZ can discriminate significant prostatic cancer through reduced kurtosis of the ADC-histogram where significant tumour is included in TZ-ROI and reduced T1 entropy independent of tumour inclusion.Key Points• MR textural features of prostate transition zone may discriminate significant prostatic cancer. • Transition zone (TZ) containing significant tumour demonstrates a less peaked ADC histogram. • TZ containing significant tumour reveals higher post-contrast T1-weighted homogeneity. • The utility of MR texture analysis in prostate cancer merits further investigation.

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Section: Discussionmentioning

confidence: 99%

“Textural analysis of multiparametric MRI detects transition zone prostate cancer”

et al. 2016

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“…A diagnosis of DCa at needle biopsy requires definitive therapy and is considered an absolute contraindication for AS [ 55 , 56 ]. Schieda et al recently demonstrated that DCa is of increased SI on T2W MRI, which can render the tumour occult [ 39 ]; however, the same authors demonstrated that DCa resembles Gleason score ≥7 or higher tumour on DWI and DCE [ 57 ]. Therefore, in a lesion with aggressive imaging findings on DWI/DCE and paradoxical increased T2W SI, DCa should be considered [ 57 ] (Fig.…”

Section: Interpretive Pitfallsmentioning

confidence: 99%

False positive and false negative diagnoses of prostate cancer at multi-parametric prostate MRI in active surveillance

et al. 2015

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MP-MRI is a critical component in active surveillance (AS) of prostate cancer (PCa) because of a high negative predictive value for clinically significant tumours. This review illustrates pitfalls of MP-MRI and how to recognise and avoid them. The anterior fibromuscular stroma and central zone are low signal on T2W-MRI/apparent diffusion coefficient (ADC), resembling PCa. Location, progressive enhancement and low signal on b ≥1000 mm²/s echo-planar images (EPI) are differentiating features. BPH can mimic PCa. Glandular BPH shows increased T2W/ADC signal, cystic change and progressive enhancement; however, stromal BPH resembles transition zone (TZ) PCa. A rounded morphology, low T2 signal capsule and posterior/superior location favour stromal BPH. Acute/chronic prostatitis mimics PCa at MP-MRI, with differentiation mainly on clinical grounds. Visual analysis of diffusion-weighted MRI must include EPI and appropriate windowing of ADC. Quantitative ADC analysis is limited by lack of standardization; the ADC ratio and ADC histogram analysis are alternatives to mean values. DCE lacks standardisation and has limited utility in the TZ, where T2W/DWI are favoured. Targeted TRUS-guided biopsies of MR-detected lesions are challenging. Lesions detected on MP-MRI may not be perfectly targeted with TRUS and this must be considered when faced with a suspicious lesion on MP-MRI and a negative targeted TRUS biopsy histopathological result.Keypoints• Multi-parametric MRI plays a critical role in prostate cancer active surveillance.• Low T2W signal intensity structures appear dark on ADC, potentially simulating cancer.• Stromal BPH mimics cancer at DWI and DCE.• Long b value trace EPI should be reviewed• Targeted biopsy of MR-detected lesions using TRUS guidance may be challenging.

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“…different scanner systems, different b-values) challenge the translation of these findings to clinical practice. Moreover, there is debate about the methodology and reproducibility of ADC measurements with the recent description of ADC ratios (normalized to non-tumorous tissues) [17], whole lesion measurement and histogram analysis including median and low percentile ADC values [18]. More advanced methods of image processing and analysis may be a next step to overcome this limitation.…”

Section: Introductionmentioning

confidence: 99%

Haralick texture analysis of prostate MRI: utility for differentiating non-cancerous prostate from prostate cancer and differentiating prostate cancers with different Gleason scores

et al. 2015

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Objectives To investigate Haralick texture analysis of prostate MRI for cancer detection and differentiating Gleason Scores (GS). Methods One hundred and forty-seven patients underwent T2- weighted (T2WI) and diffusion-weighted prostate MRI. Cancers ≥0.5ml and non-cancerous peripheral (PZ) and transition zone (TZ) tissue were identified on T2WI and apparent diffusion coefficient (ADC) maps, using whole-mount pathology as reference. Texture features (Energy, Entropy, Correlation, Homogeneity, Inertia) were extracted and analyzed using generalized estimating equations. Results PZ cancers (n=143) showed higher Entropy and Inertia and lower Energy, Correlation and Homogeneity compared to non-cancerous tissue on T2WI and ADC maps (p-values: <.0001–0.008). In TZ cancers (n=43), we observed significant differences for all five texture features on the ADC map (all p-values: <.0001) and for Correlation (p=0.041) and Inertia (p=0.001) on T2WI. On ADC maps, GS was associated with higher Entropy (GS 6 vs 7: p=0.0225; 6 vs >7: p=0.0069) and lower Energy (GS 6 vs 7: p=0.0116, 6 vs >7: p=0.0039). ADC map Energy (p=0.0102) and Entropy (p=0.0019) were significantly different in GS ≤3+4 vs. ≥4+3 cancers; ADC map Entropy remained significant after controlling for the median ADC (p=0.0291). Conclusion Several Haralick based texture features appear useful for prostate cancer detection and GS assessment.

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Multi‐parametric (mp) MRI of prostatic ductal adenocarcinoma

Abstract: Although DCa mimics Gleason score 3 + 3 = 6 tumor at T2W MRI; DCa resembles Gleason ≥7 CCa on mp-MRI.

Cited by 23 publications

References 33 publications

“Textural analysis of multiparametric MRI detects transition zone prostate cancer”

“Textural analysis of multiparametric MRI detects transition zone prostate cancer”

False positive and false negative diagnoses of prostate cancer at multi-parametric prostate MRI in active surveillance

Haralick texture analysis of prostate MRI: utility for differentiating non-cancerous prostate from prostate cancer and differentiating prostate cancers with different Gleason scores

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