Skip to main content

Advertisement

Log in

Prostate dynamic contrast-enhanced MRI with simple visual diagnostic criteria: is it reasonable?

  • Urogenital
  • Published:
European Radiology Aims and scope Submit manuscript

Abstract

The purpose of this study was to evaluate the accuracy of prostate cancer localization with simple visual diagnostic criteria using dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI). A total of 46 consecutive patients with biopsy-proven prostate cancer underwent prostate 1.5 T MRI with pelvic phased-array coils before prostatectomy. Besides the usual T2-weighted sequences, a 30-s DCE sequence was acquired three times after gadoterate injection. On DCE images, all early enhancing lesions of the peripheral zone were considered malignant. In the central gland, only early enhancing lesions appearing homogeneous or invading the peripheral zone were considered malignant. Three readers specified the presence of cancer in 20 prostate sectors and the location of distinct tumors. Results were compared with histology; p < 0.05 was considered significant. For localization of cancer in the sectors, DCE imaging had a significantly higher sensitivity [logistic regression, odds ratio (OR): 3.9, p < 0.0001] and a slightly but significantly lower specificity (OR: 0.57, p < 0.0001). Of the tumors >0.3 cc, 50–60% and 78–81% were correctly depicted with T2-weighted and DCE imaging, respectively. For both techniques, the depiction rate of tumors >0.3 cc was significantly influenced by the Gleason score (most Gleason ≤6 tumors were overlooked), but not by the tumor volume. Conclusion: DCE-MRI using pelvic phased-array coils and simple visual diagnostic criteria is more sensitive for tumor localization than T2-weighted imaging.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Jemal A, Tiwari RC, Murray T, Ghafoor A, Samuels A, Ward E, Feuer EJ, Thun MJ (2004) Cancer statistics, 2004. CA Cancer J Clin 54:8–29

    Article  PubMed  Google Scholar 

  2. Aus G, Abbou CC, Bolla M, Heidenreich A, Schmid HP, van Poppel H, Wolff J, Zattoni F (2005) EAU guidelines on prostate cancer. Eur Urol 48:546–551

    Article  PubMed  CAS  Google Scholar 

  3. Engelbrecht MR, Jager GJ, Laheij RJ, Verbeek AL, van Lier HJ, Barentsz JO (2002) Local staging of prostate cancer using magnetic resonance imaging: a meta-analysis. Eur Radiol 12:2294–2302

    PubMed  Google Scholar 

  4. Engelbrecht MR, Jager GJ, Severens JL (2001) Patient selection for magnetic resonance imaging of prostate cancer. Eur Urol 40:300–307

    Article  PubMed  CAS  Google Scholar 

  5. Jager GJ, Severens JL, Thornbury JR, de La Rosette JJ, Ruijs SH, Barentsz JO (2000) Prostate cancer staging: should MR imaging be used?-A decision analytic approach. Radiology 215:445–451

    PubMed  CAS  Google Scholar 

  6. Rouviere O, Hartman RP, Lyonnet D (2006) Prostate MR imaging at high-field strength: evolution or revolution? Eur Radiol 16:276–284

    Article  PubMed  Google Scholar 

  7. Schlemmer HP, Corvin S (2004) Methods for volume assessment of prostate cancer. Eur Radiol 14:597–606

    Article  PubMed  Google Scholar 

  8. Engelbrecht MR, Huisman HJ, Laheij RJ, Jager GJ, van Leenders GJ, Hulsbergen-Van De Kaa CA, de la Rosette JJ, Blickman JG, Barentsz JO (2003) Discrimination of prostate cancer from normal peripheral zone and central gland tissue by using dynamic contrast-enhanced MR imaging. Radiology 229:248–254

    Article  PubMed  Google Scholar 

  9. Jager GJ, Ruijter ET, van de Kaa CA, de la Rosette JJ, Oosterhof GO, Thornbury JR, Barentsz JO (1996) Local staging of prostate cancer with endorectal MR imaging: correlation with histopathology. AJR Am J Roentgenol 166:845–852

    PubMed  CAS  Google Scholar 

  10. Quinn SF, Franzini DA, Demlow TA, Rosencrantz DR, Kim J, Hanna RM, Szumowski J (1994) MR imaging of prostate cancer with an endorectal surface coil technique: correlation with whole-mount specimens. Radiology 190:323–327

    PubMed  CAS  Google Scholar 

  11. Coakley FV, Kurhanewicz J, Lu Y, Jones KD, Swanson MG, Chang SD, Carroll PR, Hricak H (2002) Prostate cancer tumor volume: measurement with endorectal MR and MR spectroscopic imaging. Radiology 223:91–97

    Article  PubMed  Google Scholar 

  12. Scheidler J, Hricak H, Vigneron DB, Yu KK, Sokolov DL, Huang LR, Zaloudek CJ, Nelson SJ, Carroll PR, Kurhanewicz J (1999) Prostate cancer: localization with three-dimensional proton MR spectroscopic imaging-clinicopathologic study. Radiology 213:473–480

    PubMed  CAS  Google Scholar 

  13. Zakian KL, Sircar K, Hricak H, Chen HN, Shukla-Dave A, Eberhardt S, Muruganandham M, Ebora L, Kattan MW, Reuter VE, Scardino PT, Koutcher JA (2005) Correlation of proton MR spectroscopic imaging with gleason score based on step-section pathologic analysis after radical prostatectomy. Radiology 234:804–814

    Article  PubMed  Google Scholar 

  14. Dhingsa R, Qayyum A, Coakley FV, Lu Y, Jones KD, Swanson MG, Carroll PR, Hricak H, Kurhanewicz J (2004) Prostate cancer localization with endorectal MR imaging and MR spectroscopic imaging: effect of clinical data on reader accuracy. Radiology 230:215–220

    Article  PubMed  Google Scholar 

  15. Padhani AR, Gapinski CJ, Macvicar DA, Parker GJ, Suckling J, Revell PB, Leach MO, Dearnaley DP, Husband JE (2000) Dynamic contrast enhanced MRI of prostate cancer: correlation with morphology and tumour stage, histological grade and PSA. Clin Radiol 55:99–109

    Article  PubMed  CAS  Google Scholar 

  16. Turnbull LW, Buckley DL, Turnbull LS, Liney GP, Knowles AJ (1999) Differentiation of prostatic carcinoma and benign prostatic hyperplasia: correlation between dynamic Gd-DTPA-enhanced MR imaging and histopathology. J Magn Reson Imaging 9:311–316

    Article  PubMed  CAS  Google Scholar 

  17. Rouviere O, Raudrant A, Ecochard R, Colin-Pangaud C, Pasquiou C, Bouvier R, Marechal JM, Lyonnet D (2003) Characterization of time-enhancement curves of benign and malignant prostate tissue at dynamic MR imaging. Eur Radiol 13:931–942

    PubMed  Google Scholar 

  18. Preziosi P, Orlacchio A, Di Giambattista G, Di Renzi P, Bortolotti L, Fabiano A, Cruciani E, Pasqualetti P (2003) Enhancement patterns of prostate cancer in dynamic MRI. Eur Radiol 13:925–930

    PubMed  Google Scholar 

  19. Schlemmer HP, Merkle J, Grobholz R, Jaeger T, Michel MS, Werner A, Rabe J, van Kaick G (2004) Can pre-operative contrast-enhanced dynamic MR imaging for prostate cancer predict microvessel density in prostatectomy specimens? Eur Radiol 14:309–317

    Article  PubMed  Google Scholar 

  20. Buckley DL, Roberts C, Parker GJ, Logue JP, Hutchinson CE (2004) Prostate cancer: evaluation of vascular characteristics with dynamic contrast-enhanced T1-weighted MR imaging-initial experience. Radiology 233:709–715

    Article  PubMed  Google Scholar 

  21. van Dorsten FA, van der Graaf M, Engelbrecht MR, van Leenders GJ, Verhofstad A, Rijpkema M, de la Rosette JJ, Barentsz JO, Heerschap A (2004) Combined quantitative dynamic contrast-enhanced MR imaging and (1)H MR spectroscopic imaging of human prostate cancer. J Magn Reson Imaging 20:279–287

    Article  PubMed  Google Scholar 

  22. Huisman HJ, Engelbrecht MR, Barentsz JO (2001) Accurate estimation of pharmacokinetic contrast-enhanced dynamic MRI parameters of the prostate. J Magn Reson Imaging 13:607–614

    Article  PubMed  CAS  Google Scholar 

  23. Fan X, Medved M, River JN, Zamora M, Corot C, Robert P, Bourrinet P, Lipton M, Culp RM, Karczmar GS (2004) New model for analysis of dynamic contrast-enhanced MRI data distinguishes metastatic from nonmetastatic transplanted rodent prostate tumors. Magn Reson Med 51:487–494

    Article  PubMed  CAS  Google Scholar 

  24. Kiessling F, Lichy M, Grobholz R, Heilmann M, Farhan N, Michel MS, Trojan L, Ederle J, Abel U, Kauczor HU, Semmler W, Delorme S (2004) Simple models improve the discrimination of prostate cancers from the peripheral gland by T1-weighted dynamic MRI. Eur Radiol 14:1793–1801

    PubMed  Google Scholar 

  25. Ogura K, Maekawa S, Okubo K, Aoki Y, Okada T, Oda K, Watanabe Y, Tsukayama C, Arai Y (2001) Dynamic endorectal magnetic resonance imaging for local staging and detection of neurovascular bundle involvement of prostate cancer: correlation with histopathologic results. Urology 57:721–726

    Article  PubMed  CAS  Google Scholar 

  26. Rouviere O, Valette O, Grivolat S, Colin-Pangaud C, Bouvier R, Chapelon JY, Gelet A, Lyonnet D (2004) Recurrent prostate cancer after external beam radiotherapy: value of contrast-enhanced dynamic MRI in localizing intraprostatic tumor-correlation with biopsy findings. Urology 63:922–927

    Article  PubMed  Google Scholar 

  27. Tanaka N, Samma S, Joko M, Akiyama T, Takewa M, Kitano S, Okajima E (1999) Diagnostic usefulness of endorectal magnetic resonance imaging with dynamic contrast-enhancement in patients with localized prostate cancer: mapping studies with biopsy specimens. Int J Urol 6:593–599

    Article  PubMed  CAS  Google Scholar 

  28. Ikonen S, Karkkainen P, Kivisaari L, Salo JO, Taari K, Vehmas T, Tervahartiala P, Rannikko S (2001) Endorectal magnetic resonance imaging of prostatic cancer: comparison between fat-suppressed T2-weighted fast spin echo and three-dimensional dual-echo, steady-state sequences. Eur Radiol 11:236–241

    Article  PubMed  CAS  Google Scholar 

  29. Schiebler ML, Tomaszewski JE, Bezzi M, Pollack HM, Kressel HY, Cohen EK, Altman HG, Gefter WB, Wein AJ, Axel L (1989) Prostatic carcinoma and benign prostatic hyperplasia: correlation of high-resolution MR and histopathologic findings. Radiology 172:131–137

    PubMed  CAS  Google Scholar 

  30. Husband JE, Padhani AR, MacVicar AD, Revell P (1998) Magnetic resonance imaging of prostate cancer: comparison of image quality using endorectal and pelvic phased array coils. Clin Radiol 53:673–681

    Article  PubMed  CAS  Google Scholar 

  31. Soulie M, Aziza R, Escourrou G, Seguin P, Tollon C, Molinier L, Bachaud J, Joffre F, Plante P (2001) Assessment of the risk of positive surgical margins with pelvic phased-array magnetic resonance imaging in patients with clinically localized prostate cancer: a prospective study. Urology 58:228–232

    Article  PubMed  CAS  Google Scholar 

  32. Puech P, Faivre JB, Ballereau C, Leroy X, Villers A, Lemaître L (2004) Etude comparative de l'IRM de prostate par voie suspubienne ou endorectale. J Radiol 85:1402

    Article  Google Scholar 

  33. Stamey TA, Freiha FS, McNeal JE, Redwine EA, Whittemore AS, Schmid HP (1993) Localized prostate cancer. Relationship of tumor volume to clinical significance for treatment of prostate cancer. Cancer 71:933–938

    Article  PubMed  CAS  Google Scholar 

  34. Akin O, Sala E, Moskowitz CS, Kuroiwa K, Ishill NM, Pucar D, Scardino PT, Hricak H (2006) Transition zone prostate cancers: features, detection, localization, and staging at endorectal MR imaging. Radiology 239:784–792

    Article  PubMed  Google Scholar 

  35. White S, Hricak H, Forstner R, Kurhanewicz J, Vigneron DB, Zaloudek CJ, Weiss JM, Narayan P, Carroll PR (1995) Prostate cancer: effect of postbiopsy hemorrhage on interpretation of MR images. Radiology 195:385–390

    PubMed  CAS  Google Scholar 

  36. Ikonen S, Kivisaari L, Vehmas T, Tervahartiala P, Salo JO, Taari K, Rannikko S (2001) Optimal timing of post-biopsy MR imaging of the prostate. Acta Radiol 42:70–73

    Article  PubMed  CAS  Google Scholar 

  37. Qayyum A, Coakley FV, Lu Y, Olpin JD, Wu L, Yeh BM, Carroll PR, Kurhanewicz J (2004) Organ-confined prostate cancer: effect of prior transrectal biopsy on endorectal MRI and MR spectroscopic imaging. AJR Am J Roentgenol 183:1079–1083

    PubMed  Google Scholar 

  38. Gossmann A, Okuhata Y, Shames DM, Helbich TH, Roberts TP, Wendland MF, Huber S, Brasch RC (1999) Prostate cancer tumor grade differentiation with dynamic contrast-enhanced MR imaging in the rat: comparison of macromolecular and small-molecular contrast media-preliminary experience. Radiology 213:265–272

    PubMed  CAS  Google Scholar 

  39. Schick F (2005) Whole-body MRI at high field: technical limits and clinical potential. Eur Radiol 15:946–959

    Article  PubMed  Google Scholar 

  40. Futterer JJ, Heijmink SW, Scheenen TW, Jager GJ, Hulsbergen-Van de Kaa CA, Witjes JA, Barentsz JO (2006) Prostate cancer: local staging at 3-T endorectal MR imaging-early experience. Radiology 238:184–191

    Article  PubMed  Google Scholar 

  41. Bloch BN, Rofsky NM, Baroni RH, Marquis RP, Pedrosa I, Lenkinski RE (2004) 3 Tesla magnetic resonance imaging of the prostate with combined pelvic phased-array and endorectal coils; Initial experience. Acad Radiol 11:863–867

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Olivier Rouvière.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Girouin, N., Mège-Lechevallier, F., Tonina Senes, A. et al. Prostate dynamic contrast-enhanced MRI with simple visual diagnostic criteria: is it reasonable?. Eur Radiol 17, 1498–1509 (2007). https://doi.org/10.1007/s00330-006-0478-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-006-0478-9

Keywords

Navigation