Can pre-operative contrast-enhanced dynamic MR imaging for prostate cancer predict microvessel density in prostatectomy specimens?
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.
Schlemmer
Heinz-Peter
HP
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
Merkle
Jonas
J
Grobholz
Rainer
R
Jaeger
Tim
T
Michel
Maurice Stephan
MS
Werner
Axel
A
Rabe
Jan
J
van Kaick
Gerhard
G
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
D003287:Contrast Media; D019786:Gadolinium DTPA