Guang Jia PhD, Presenter: Nothing to Disclose

Zarine Ketul Shah MD, Abstract Co-Author: Nothing to Disclose

Steffen Sammet MD, PhD, Abstract Co-Author: Nothing to Disclose

Vipul R. Patel MD, Abstract Co-Author: Nothing to Disclose

Douglas D. Martin MD, Abstract Co-Author: Nothing to Disclose

Michael Vinzenz Knopp MD, PhD, Abstract Co-Author: Nothing to Disclose

Ketul Shah, Abstract Co-Author: Nothing to Disclose

Nina A. Mayr MD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

Prostate cancer detection in the transition zone is challenged by its high vascularity and frequent occurrence of BPH. This study investigates if combination of T2-measurement and functional MRI (prostatic diffusion and perfusion) improves the differentiation of prostatic tissues imaged at 3T without using an endorectal coil.

32 patients (60 ± 8 years) with clinically proven prostate cancer were imaged in a 3 Tesla MR system (Achieva, Philips) using a phased-array coil. Besides standard morphological imaging, diffusion weighted MRI was performed with a single shot EPI sequence with 4 b-values from 0 to 1000 s/mm2, from which apparent diffusion coefficient (ADC) maps were calculated. T2-mapping were acquired using a multi-shot TSE sequence with 10 TE values from 12 to 120 ms. Prostatic perfusion was evaluated by using a 3D T1w FFE DCE-MRI sequence. In perfusion analysis, semi-quantitative parameters (time to maximum enhancement and maximum enhancement ratio, MER) and pharmacokinetic parameters (Amp, exchange rate constant, and elimination factor) were evaluated in abnormal regions, peripheral and transition zone. The suspected tumor was correlated with biopsy (N=12) and prostatectomy specimen (N=20).

Significant differences were found in ADC values between prostate cancer (0.81 ± 0.06 x 10-3 mm2/s), peripheral zone (1.70 ± 0.22 x 10-3 mm2/s) (p=0.03), and transition zone (1.53 ± 0.05 x 10-3 mm2/s) (p=0.001). Prostate cancer showed significantly (p=0.03) lower T2 values of 92 ± 12 ms, versus 136 ± 40 ms in peripheral zone. Among perfusion parameters, significant differences were found in MER between prostate cancer (2.7 ± 0.9) and peripheral zone (2.1 ± 1.2) (p<0.001).

Multi-functional prostate imaging enables improved differentiation of prostate cancer from both the transition and peripheral zones and has the potential to further advance non-invasive assessment even without using an endorectal coil.

Improving cancer delineation especially in the transition zone can be achieved by multi-functional MR at 3T advancing the non-invasive capabilities.

Jia, G, Shah, Z, Sammet, S, Patel, V, Martin, D, Knopp, M, Shah, K, Mayr, N, et al, , et al, , Combination of Multi-functional MR at 3T for Prostate Cancer Detection: T2 Mapping, Diffusion-Weighted MRI, and DCE-MRI.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5009386.html