Tom W.j. Scheenen PhD, Presenter: Research Grant, Siemens AG

Alan Wright, Abstract Co-Author: Nothing to Disclose

Kirsten Selnaes, Abstract Co-Author: Nothing to Disclose

Masoom A. Haider MD, Abstract Co-Author: Consultant, Bayer AG

Katarzyna J. Macura MD, PhD, Abstract Co-Author: Nothing to Disclose

Daniel Jason Aaron Margolis MD, Abstract Co-Author: Research Grant, Siemens AG

Berthold Kiefer PhD, Abstract Co-Author: Employee, Siemens AG

Marnix C. Maas PhD, Abstract Co-Author: Nothing to Disclose

Jurgen J. Futterer MD, PhD, Abstract Co-Author: Nothing to Disclose

To prove the diagnostic accuracy of 3T multi-parametric MR imaging (mpMRI) in a multi-center setting for distinguishing clinically significant prostate cancer from other prostate tissue

mpMRI in PCaMAP(NCT01138527) exists of high resolution T2-weighted imaging, diffusion weighted imaging (DWI), dynamic contrast enhanced (DCE) imaging and 1H-spectroscopic imaging (MRSI) at 3T without an endorectal coil (ERC). Fifty patients from 5 institutions (mean±SD age 61±7y, PSA 7.4±3.5 ng/ml) underwent identical scanning protocols on 3T MRI systemsbefore radical prostatectomy. All data was centrally analyzed. From histopathology, 1.0 cc spherical ROIs were drawn on T2w MRI, and functional parameters were extracted for tumor and healthy tissues.

70 tumors were annotated (54 in peripheral zone,16 in transition zone). 1756 ROIs were annotated (349 original, 1407 nearest neighbors), of which 712 (136 original) were in prostate cancer. Automatic QC passed 53% of MRSI voxels (worst-performing center 28%, best-performing center 68%). Significant differences between non-cancer PZ and PCa were found for ADC , (Choline+Spermine+Creatine)/Citrate [CSC/C], Choline/(Spermine+Creatine) [C/SC], Ktrans and ve (all p<0.001). Significant differences between non-cancer CG and PCa were found for ADC (p<0.001) and C/SC (p<0.05). ROC analysis resulted in AUC comparable to literature values for ADC, but lower than previously published values for MRSI and DCE parameters. A Logistic Regression Model including ADC, CSC/C and Ktrans did not yield an improvement over using ADC alone.

Using identical scanning protocols at 3T without an ERC in a multi-center setting yields good separation of PCa tissue from non-cancer tissues with ADC maps. Data analysis of DCE and MRSI needs further steps before definite conclusions about the multi-center performance of these methods can be drawn. The validation part of this prospective trial will be used to determine the parameters contributing most to the detection and localization of clinically significant PCa as well as their optimal threshold values.  

In a multi-center setting, mpMRI of the prostate at 3 Tesla can discriminate between cancer and non-cancer tissue. With identical scanning protocols, homogeneous mpMRI data can be acquired across different institutions

Scheenen, T, Wright, A, Selnaes, K, Haider, M, Macura, K, Margolis, D, Kiefer, B, Maas, M, Futterer, J, Prostate Cancer Localization with a Multiparametric MR Approach (PCaMAP): Initial Validation of a Prospective Multi-center Study.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014768.html