MR-perfusion (MRP) and diffusion-weighted imaging (DWI) in prostate cancer: Quantitative and model-based gadobenate dimeglumine MRP parameters in detection of prostate cancer

作者：Scherr M K^*; Seitz M; Mueller Lisse U G; Ingrisch M; Reiser M F; Mueller Lisse U L

来源：European Journal of Radiology, 2010, 76(3): 359-366.

DOI：10.1016/j.ejrad.2010.04.023

• Prostate cancer
• Magnetic resonance imaging
• Magnetic resonance spectroscopy
• Diffusion-weighted imaging
• Dynamic contrast-enhanced MRI
• Perfusion
• Quantitative parameters

Background: Various MR methods, including MR-spectroscopy (MRS), dynamic, contrast-enhanced MRI (DCE-MRI), and diffusion-weighted imaging (DWI) have been applied to improve test quality of standard MRI of the prostate.
Purpose: To determine if quantitative, model-based MR-perfusion (MRP) with gadobenate dimeglumine (Gd-BOPTA) discriminates between prostate cancer, benign tissue, and transitional zone (TZ) tissue.
Material and methods: 27 patients (age, 65 +/- 4 years; PSA 11.0 +/- 6.1 ng/ml) with clinical suspicion of prostate cancer underwent standard MRI, 3D MR-spectroscopy (MRS), and MRP with Gd-BOPTA. Based on results of combined MRI/MRS and subsequent guided prostate biopsy alone (17/27), biopsy and radical prostatectomy (9/27), or sufficient negative follow-up (7/27), maps of model-free, deconvolution-based mean transit time (dMTT) were generated for 29 benign regions (bROIs), 14 cancer regions (cROIs), and 18 regions of transitional zone (tzROIs). Applying a 2-compartment exchange model, quantitative perfusion analysis was performed including as parameters: plasma flow (PF), plasma volume (PV), plasma mean transit time (PMTT), extractionflow(EFL), extraction fraction (EFR), interstitial volume (IV) and interstitial mean transit time (IMTT). Two-sided T-tests (significance level p < 0.05) discriminated bROIs vs. cROIs and cROIs vs. tzROIs, respectively.
Results: PMTT discriminated best between bROIs (11.8 +/- 3.0 s) and cROIs (24.3 +/- 9.6 s) (p < 0.0001), while PF, PV, PS, EFR, IV, IMTT also differed significantly (p 0.00002-0.0136). Discrimination between cROIs and tzROIs was insignificant for all parameters except PV (14.3 +/- 2.5 ml vs. 17.6 +/- 2.6 ml, p < 0.05).
Conclusions: Besides MRI, MRS and DWI quantitative, 2-compartment MRP with Gd-BOPTA discriminates between prostate cancer and benign tissue with several parameters. However, distinction of prostate cancer and TZ does not appear to be reliable.

• 出版日期2010-12