Dynamic contrast enhanced, pelvic phased array magnetic resonance imaging of localized prostate cancer for predicting tumor volume: correlation with radical prostatectomy findings.
OBJECTIVE
We assessed the value of pelvic phased array dynamic contrast enhanced magnetic resonance imaging for predicting the intraprostatic location and volume of clinically localized prostate cancers.


METHODS
Suspicious areas on prospective pre-biopsy magnetic resonance imaging in 24 patients were assigned a magnetic resonance imaging malignancy score and located with respect to anatomical features, gland side, and transition and peripheral zone boundaries. The largest surface area and volume were measured. These magnetic resonance imaging findings were compared with radical prostatectomy specimen histopathology findings.


RESULTS
Histopathology maps detected 56 separate cancer foci. The largest tumor focus was located in the peripheral zone in 14 patients and in the transition zone in 10. T1-weighted dynamic contrast enhanced magnetic resonance imaging identified 30 of the 39 tumor foci greater than 0.2 cc and 27 of the 30 greater than 0.5 cc. T2-weighted sequences were suspicious in 22 of 30 foci greater than 0.2 cc that were identified by T1-weighted dynamic contrast enhanced magnetic resonance imaging sequences. Sensitivity, specificity, and positive and negative predictive values for cancer detection by magnetic resonance imaging were 77%, 91%, 86% and 85% for foci greater than 0.2 cc, and 90%, 88%, 77% and 95% for foci greater than 0.5 cc, respectively. Median focus volume was 1.37 cc (range 0.338 to 6.32) for foci greater than 0.2 cc detected by magnetic resonance imaging in the peripheral zone and 0.503 cc (range 0.337 to 1.345) for those not detected by magnetic resonance imaging (p <0.05). Corresponding median values for transition zone foci were 2.54 (range 0.75 to 16.87) and 0.435 (range 0.26 to 0.58).


CONCLUSIONS
Pre-biopsy pelvic phased array dynamic contrast enhanced magnetic resonance imaging is an accurate technique for detecting and quantifying intracapsular transition or peripheral zone tumor foci greater than 0.2 cc. It has promising implications for cancer detection, prognosis and treatment.
Villers
Arnauld
A
Department of Urology, Hospital Claude Huriez, Centre Hospitalier Régional Universitaire de Lille, 59037 Lille, France. a-villers@chru-lille.fr
Puech
Philippe
P
Mouton
Damien
D
Leroy
Xavier
X
Ballereau
Charles
C
Lemaitre
Laurent
L
D000368:Aged; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery*; D012680:Sensitivity and Specificity