Open Access

ARTICLE

Association of quantitative magnetic resonance imaging parameters with histological fndings from MRI/ultrasound fusion prostate biopsy

Seyed Saeid Dianat¹, H. Ballentine Carter^2,4, Edward M. Schaeffer^2,4, Ulrike M. Hamper^1,2, Jonathan I. Epstein^2,3,4, Katarzyna J. Macura^1,2,4

1 The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA
2 The James Buchanan Brady Urological Institute, The Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA
3 Department of Pathology, The Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA
4 The Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA
Address correspondence to Dr. Katarzyna J. Macura, The RussellH. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University, School of Medicine, 601N. Caroline Street, JHOC 3140C, Baltimore, MD 21287 USA

Canadian Journal of Urology 2015, 22(5), 7965-7972.

Abstract

Introduction: Purpose of this pilot study was to correlate quantitative parameters derived from the multiparametric magnetic resonance imaging (MP-MRI) of the prostate with results from MRI guided transrectal ultrasound (MRI/TRUS) fusion prostate biopsy in men with suspected prostate cancer.
Materials and methods: Thirty-nine consecutive patients who had 3.0T MP-MRI and subsequent MRI/TRUS fusion prostate biopsy were included and 73 MRI-identified targets were sampled by 177 cores. The pre-biopsy MP-MRI consisted of T2-weighted, diffusion weighted (DWI), and dynamic contrast enhanced (DCE) images. The association of quantitative MRI measurements with biopsy histopathology findings was assessed by Mann-Whitney U-test and Kruskal-Wallis test.
Results: Of 73 targets, biopsy showed benign prostate tissue in 46 (63%), cancer in 23 (31.5%), and atypia/high grade prostatic intraepithelial neoplasia in four (5.5%) targets. The median volume of cancer-positive targets was 1.3 cm³. The cancer-positive targets were located in the peripheral zone (56.5%), transition zone (39.1%), and seminal vesicle (4.3%). Nine of 23 (39.1%) cancer-positive targets were higher grade cancer (Gleason grade >6). Higher grade targets and cancer-positive targets compared to benign lesions exhibited lower mean apparent diffusion coefficient (ADC) value (952.7 < 1167.9 < 1278.9), and lower minimal extracellular volume fraction (ECF) (0.13 < 0.185 < 0.213), respectively. The difference in parameters was more pronounced between higher grade cancer and benign lesions.
Conclusions: Our findings from a pilot study indicate that quantitative MRI parameters can predict malignant histology on MRI/TRUS fusion prostate biopsy, which is a valuable technique to ensure adequate sampling of MRI-visible suspicious lesions under TRUS guidance and may impact patient management. The DWI-based quantitative measurement exhibits a stronger association with biopsy findings than the other MRI parameters.

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