Open Access

ARTICLE

Prospective evaluation of the value of dynamic contrast enhanced (DCE) imaging for prostate cancer detection, with pathology correlation

Ishaq Al Salmi¹, Terence Menezes¹, Mohamed EL-Khodary¹, Sandra Monteiro², Ehsan A. Haider¹, Abdullah Alabousi¹

1 Department of Radiology, St. Joseph’s Healthcare Hamilton, Hamilton, Ontario, Canada
2 Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
Address correspondence to Dr. Abdullah Alabousi, Department of Radiology, St. Joseph’s Healthcare Hamilton, 50 Charlton Ave E., Hamilton, ON L8N 4A6 Canada

Canadian Journal of Urology 2020, 27(3), 10220-10227.

Abstract

Introduction: The aim of this study was to evaluate the value of dynamic contrast enhanced (DCE) imaging in multi-parametric prostate MRI (mpMRI) for the detection and staging of prostate cancer in comparison with T2W and DWI images alone in biparametric MRI (bpMRI) in treatment-naïve patients.
Materials and methods: One hundred consecutive patients who underwent a prostate MRI at our institution from June-August 2017, as well as a systematic ultrasound-guided prostate biopsy or prostatectomy, were included. Strictly following PI-RADS v2, the MRI studies were independently interpreted by a body radiologist and a body-imaging fellow on two different occasions 8-10 weeks apart. Initially, with all mpMRI sequences and then without the DCE sequence (bpMRI). The readers were blinded to the clinical information. Ethics approval was obtained.
Results: One hundred treatment-naïve patients were included (median age 64, age range 48-81, mean PSA 10.3). There was almost perfect intra-observer agreement for mpMRI versus bpMRI for both readers [Cohen’s Kappa (k) 0.88-0.86] and substantial inter-observer agreement (k = 0.74 for mpMRI and 0.76 for bpMRI). The sensitivity and specificity did not significantly change between multi-parametric and bi-parametric MRI (Sensitivity 91.7% and 90%, Specificity of 85.5% and 85% for mpMRI and bpMRI, respectively).
Conclusion: Based on our findings, prostate MRI without DCE (bpMRI) is of comparable diagnostic accuracy to mpMRI in treatment-naïve patients. Performing prostate MRI without DCE (bpMRI) will reduce acquisition time, decrease cost, and potentially improve patient safety.

---

Keywords

---