Performance of Ultrafast DCE-MRI for Diagnosis of Prostate Cancer

Chatterjee, Aritrick; He, Dakuo; Fan, Xiaobing; Wang, Shiyang; Szasz, Teodora; Yousuf, Ambereen; Pineda, Federico; Antic, Tatjana; Mathew, Melvy Sarah; Karczmar, Gregory S.; Oto, Aytekin

doi:10.1016/j.acra.2017.10.004

Cited by 32 publications

(29 citation statements)

References 49 publications

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“…Although the precise physiological explanation of enhancement on DCE remains ambiguous (e.g., angiogenesis and increased microvessel density) [ 19 ], early intensity changes were indicative for malignancy ( Figure 2 ). This is in line with studies in breast cancer with an earlier time of arrival of contrast bolus in the malignant lesion [ 15 , 16 , 17 ]. Although the thin mucosal hypervascular layer and normal tonsillar tissue might interfere with the detection UPT, no other hypervascular lesions are generally present in the head and neck area.…”

Section: Discussionsupporting

confidence: 90%

“…Quantification based on delineated region of interest, has been introduced previously in DCE [ 15 , 16 ] in order to optimize detecting occult primary tumors. Although voluminous quantitative parameters did not showed increased accuracy [ 1 ], semi-quantitative parameters describing the area under the curve, time-to-peak or upslope angle might increase detection performance, and should be assessed in future studies.…”

Section: Discussionmentioning

confidence: 99%

“…Ultrafast-DCE with a high temporal resolution (i.e., <10 s per stack of images) captures details of the first contrast uptake kinetics and increased the diagnostic performance for tumor detection in prostate [ 15 ] and breast cancer [ 16 , 17 ]. The principle of discrimination between benign and malignant lesions is based on the earlier time of arrival of the contrast in malignancies with increased neoangiogenesis or perfusion compared to normal tissue.…”

Section: Introductionmentioning

confidence: 99%

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The Additional Value of Ultrafast DCE-MRI to DWI-MRI and 18F-FDG-PET to Detect Occult Primary Head and Neck Squamous Cell Carcinoma

Martens

Stappen²,

Koopman

et al. 2020

Cancers

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To evaluate diagnostic accuracy of qualitative analysis and interobserver agreement of single ultrafast-DCE, DWI or 18F-FDG-PET and the combination of modalities for the detection of unknown primary tumor (UPT) in patients presenting with cervical lymph node metastasis from squamous cell carcinoma (SCC). Between 2014–2019, patients with histologically proven cervical lymph node metastasis of UPT SCC were prospectively included and underwent DWI, ultrafast-DCE, and 18F-FDG-PET/CT. Qualitative assessment was performed by two observers per modality. Interobserver agreement was calculated using the proportion specific agreement. Diagnostic accuracy of combined use of DWI, ultrafast-DCE and 18F-FDG-PET/CT was assessed. Twenty-nine patients were included (20 males. [68%], median age 60 years). Nine (31%) primary tumors remained occult. Ultrafast-DCE added reader confidence for suspicious locations (one additional true positive (5%), 2 decisive true malignant (10%). The per-location analysis showed highest specific positive agreement for ultrafast-DCE (77.6%). The per-location rating showed highest sensitivity (95%, 95%CI = 75.1–99.9, YI = 0.814) when either one of all modalities was scored positive, and 97.4% (95%CI = 93.5–99.3, YI = 0.774) specificity when co-detected on all. The per-patient analysis showed highest sensitivity (100%) for 18F-FDG-PET/CT (YI = 0.222) and either DWI or PET (YI = 0.111). Despite highest trends, no significant differences were found. The per-patient analysis showed highest specific positive agreement when co-detected on all modalities (55.6%, 95%CI = 21.2–86.3, YI = 0.456). Ultrafast-DCE showed potential to improve detection of unknown primary tumors in addition to DWI and 18F-FDG-PET/CT in patients with cervical squamous cell carcinoma lymph node metastasis. The combined use of ultrafast-DCE, DWI and 18F-FDG-PET/CT yielded highest sensitivity.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Additional Value of Ultrafast DCE-MRI to DWI-MRI and 18F-FDG-PET to Detect Occult Primary Head and Neck Squamous Cell Carcinoma

Martens

Stappen²,

Koopman

et al. 2020

Cancers

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“…The baseline signal intensity value ( S 0 ) of each voxel was calculated by averaging the signal intensity ( S(t) ) of the five pre-contrast time points. Then, the percentage signal enhancement ( PSE ) as a function of time was calculated as: italicPSE(t)=S(t)−S0S00.2em×100The initial time of enhancement for each voxel was found using an iterative method described in a previous study (29). The maximum enhancement projections (MEP) were generated by finding the maximum PSE value of each voxel.…”

Section: Methodsmentioning

confidence: 99%

Feasibility of Dynamic Contrast-Enhanced Magnetic Resonance Imaging Using Low-Dose Gadolinium

He¹,

Chatterjee

Fan

et al. 2018

Invest Radiol

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These preliminary results suggest that DCE-MRI with a low GBCA dose distinguishes PCa from benign prostate tissue more effectively than does the standard GBCA dose, based on signal enhancement rate. Diagnostic accuracy is similar on qualitative assessment. Prostate cancer diagnosis may be feasible with DCE-MRI with low-dose GBCA. In addition, comparison of enhancement kinetics after low and high doses of contrast media may provide diagnostically useful information.

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“…Multiparametric MR images for all 76 patients were loaded on a PCampReview custom module in an open-source software platform for medical image informatics, image processing, and 3D visualization (3D Slicer) [21]. Two radiologists with 15 and 3 years of experience in prostate MRI who were blinded to the pathologic results reviewed the T2-weighted images and drew ROIs on wedge-shaped areas of hypointensity on the T2-weighted images.…”

Section: Methodsmentioning

confidence: 99%

Multiparametric MRI Features and Pathologic Outcome of Wedge-Shaped Lesions in the Peripheral Zone on T2-Weighted Images of the Prostate

Chatterjee

Tokdemir

Gallan

et al. 2019

American Journal of Roentgenology

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OBJECTIVE. This study investigates the multiparametric MRI (mpMRI) characteristics and pathologic outcome of wedge-shaped lesions observed on T2-weighted images. MATERIALS AND METHODS. Seventy-six patients with histologically confirmed prostate cancer underwent preoperative 3-T MRI before undergoing radical prostatectomy. Two radiologists worked in consensus to mark wedge-shaped regions of hypointensity on T2-weighted images and assess their appearance on apparent diffusion coefficient (ADC) maps (to determine the degree of hypointensity) and dynamic contrast-enhanced (DCE) MRI (DCE-MRI) (to assess whether they showed early enhancement). The pathologic outcome of wedge-shaped lesions was assessed by matching MR images with whole-mount histologic specimens retrospectively. The difference in quantitative ADC values between malignant and benign wedge-shaped lesions was assessed using a t test. RESULTS. Thirty-five wedge-shaped regions were identified, 12 (34%) of which were found be malignant. Most malignant wedge-shaped regions were highly hypointense (10/12; 83%) on ADC maps and showed early enhancement on DCE-MRI (7/12; 58%). However, benign wedge-shaped lesions were predominantly mildly hypointense (13/23; 57%) on ADC maps and showed no early enhancement (15/23; 65%). Histologic correlates of the benign wedge-shaped regions showed prostatitis (acute inflammation [7/23; 30%] or chronic inflammation [9/23; 39%]), hemosiderin-laden macrophages (6/23; 26%), prominent blood vessels (7/23; 30%), intraluminal blood (6/23; 26%), and nonspecific atrophy (6/23; 26%). The mean (± SD) quantitative ADC value of malignant wedge-shaped regions (1.13 ± 0.11 μm2/ms) was significantly lower (p = 0.0001) than that of benign wedge-shaped regions (1.52 ± 0.27 μm2/ms). CONCLUSION. This study shows that a greater percentage of wedge-shaped features are malignant than was previously thought. Of importance, mpMRI (specifically, ADC maps) can distinguish between malignant and benign wedge-shaped features.

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Performance of Ultrafast DCE-MRI for Diagnosis of Prostate Cancer

Cited by 32 publications

References 49 publications

The Additional Value of Ultrafast DCE-MRI to DWI-MRI and 18F-FDG-PET to Detect Occult Primary Head and Neck Squamous Cell Carcinoma

The Additional Value of Ultrafast DCE-MRI to DWI-MRI and 18F-FDG-PET to Detect Occult Primary Head and Neck Squamous Cell Carcinoma

Feasibility of Dynamic Contrast-Enhanced Magnetic Resonance Imaging Using Low-Dose Gadolinium

Multiparametric MRI Features and Pathologic Outcome of Wedge-Shaped Lesions in the Peripheral Zone on T2-Weighted Images of the Prostate

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