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European Radiology
Published in: European Radiology 8/2018

Open Access 01-08-2018 | Urogenital

Diagnostic evaluation of magnetization transfer and diffusion kurtosis imaging for prostate cancer detection in a re-biopsy population

Authors: Tristan Barrett, Mary McLean, Andrew N. Priest, Edward M. Lawrence, Andrew J. Patterson, Brendan C. Koo, Ilse Patterson, Anne Y. Warren, Andrew Doble, Vincent J. Gnanapragasam, Christof Kastner, Ferdia A. Gallagher

Published in: European Radiology | Issue 8/2018

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Abstract

Objective

To evaluate diffusion kurtosis imaging (DKI) and magnetisation transfer imaging (MTI) compared to standard MRI for prostate cancer assessment in a re-biopsy population.

Methods

Thirty-patients were imaged at 3 T including DKI (Kapp and Dapp) with b-values 150/450/800/1150/1500 s/mm2 and MTI performed with and without MT saturation. Patients underwent transperineal biopsy based on prospectively defined MRI targets. Receiver-operating characteristic (ROC) analyses assessed the parameters and Wilcoxon-signed ranked test assessed relationships between metrics.

Results

Twenty patients had ≥ 1 core positive for cancer in a total of 26 MRI targets (Gleason 3+3 in 8, 3+4 in 12, ≥ 4+3 in 6): 13 peripheral (PZ) and 13 transition zone (TZ). The apparent diffusion coefficient (ADC) and Dapp were significantly lower and the Kapp and MT ratio (MTR) significantly higher in tumour versus benign tissue (all p ≤ 0.005); ROC values 0.767-1.000. Normal TZ had: lower ADC and Dapp and higher Kapp and MTR compared to normal PZ. MTR showed a moderate correlation to Kapp (r = 0.570) and Dapp (r = -0.537) in normal tissue but a poor correlation in tumours. No parameter separated low-grade (Gleason 3+3) from high-grade (≥ 3+4) disease for either PZ (p = 0.414-0.825) or TZ (p = 0.148-0.825).

Conclusion

ADC, Dapp, Kapp and MTR all distinguished benign tissue from tumour, but none reliably differentiated low- from high-grade disease.

Key Points

• MTR was significantly higher in PZ and TZ tumours versus normal tissue
• K app was significantly lower and D app higher for PZ and TZ tumours
• There was no incremental value for DKI/MTI over mono-exponential ADC parameters
• No parameter could consistently differentiate low-grade (Gleason 3+3) from high-grade (≥ 3+4) disease
• Divergent MTR/DKI values in TZ tumours suggests they offer different functional information
Appendix
Available only for authorised users
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Metadata
Title
Diagnostic evaluation of magnetization transfer and diffusion kurtosis imaging for prostate cancer detection in a re-biopsy population
Authors
Tristan Barrett
Mary McLean
Andrew N. Priest
Edward M. Lawrence
Andrew J. Patterson
Brendan C. Koo
Ilse Patterson
Anne Y. Warren
Andrew Doble
Vincent J. Gnanapragasam
Christof Kastner
Ferdia A. Gallagher
Publication date
01-08-2018
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 8/2018
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-017-5169-1

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