title: Can pre-operative contrast-enhanced dynamic MR imaging for prostate cancer predict microvessel density in prostatectomy specimens?
abstract: The aim of this study was to correlate quantitative dynamic contrast-enhanced MRI (DCE MRI) parameters with microvessel density (MVD) in prostate carcinoma. Twenty-eight patients with biopsy-proven prostate carcinoma were examined by endorectal MRI including multiplanar T2- and T1-weighted spin-echo and dynamic T1-weighted turbo-FLASH MRI during and after intravenous Gd-DTPA administration. Microvessels were stained on surgical specimens using a CD31 monoclonal antibody. The MVD was quantified in hot spots by counting (MVC) and determining the area fraction by morphometry (MVAF). The DCE MRI data were analyzed using an open pharmacokinetic two-compartment model. In corresponding anatomic locations the time shift (Deltat) between the beginning of signal enhancement of cancer and adjacent normal prostatic tissue, the degree of contrast enhancement and the contrast exchange rate constant (k21) were calculated. The MVC and MVAF were elevated in carcinoma (p<0.001 and p=0.002, respectively) and correlated to k21 (r=0.62, p<0.001 and r=0.80, p<0.001, respectively). k21-values of carcinoma were significantly higher compared with normal peripheral but not central zone tissue. Deltat was longer in high compared with low-grade tumors (p=0.025). The DCE MRI can provide important information about individual MVD in prostate cancer, which may be helpful for guiding biopsy and assessing individual prognosis.
authors.affiliation: Department of Oncological Diagnostics and Therapy, German Cancer Research Center, University Hospital Mannheim, Ruprecht Karls University, Heidelberg, Germany. heinz-peter.schlemmer@med.uni-tuebingen.de
authors.forename: Heinz-Peter
authors.initials: HP
authors.lastname: Schlemmer
authors.forename: Jonas
authors.initials: J
authors.lastname: Merkle
authors.forename: Rainer
authors.initials: R
authors.lastname: Grobholz
authors.forename: Tim
authors.initials: T
authors.lastname: Jaeger
authors.forename: Maurice Stephan
authors.initials: MS
authors.lastname: Michel
authors.forename: Axel
authors.initials: A
authors.lastname: Werner
authors.forename: Jan
authors.initials: J
authors.lastname: Rabe
authors.forename: Gerhard
authors.initials: G
authors.lastname: van Kaick
mesh_terms: D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008432:Mathematical Computing; D008833:Microcirculation / Q000473:pathology; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000175:diagnosis* / Q000473:pathology; D011379:Prognosis; D011467:Prostate / Q000098:blood supply / Q000473:pathology; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000098:blood supply* / Q000473:pathology / Q000601:surgery; D012984:Software
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA