title: Multiparametric 3T prostate magnetic resonance imaging to detect cancer: histopathological correlation using prostatectomy specimens processed in customized magnetic resonance imaging based molds.
abstract: OBJECTIVE
  We determined the prostate cancer detection rate of multiparametric magnetic resonance imaging at 3T. Precise one-to-one histopathological correlation with magnetic resonance imaging was possible using prostate magnetic resonance imaging based custom printed specimen molds after radical prostatectomy.
  
  
  METHODS
  This institutional review board approved prospective study included 45 patients (mean age 60.2 years, range 49 to 75) with a mean prostate specific antigen of 6.37 ng/ml (range 2.3 to 23.7) who had biopsy proven prostate cancer (mean Gleason score of 6.7, range 6 to 9). Before prostatectomy all patients underwent prostate magnetic resonance imaging using endorectal and surface coils on a 3T scanner, which included triplane T2-weighted magnetic resonance imaging, apparent diffusion coefficient maps of diffusion weighted magnetic resonance imaging, dynamic contrast enhanced magnetic resonance imaging and spectroscopy. The prostate specimen was whole mount sectioned in a customized mold, allowing geometric alignment to magnetic resonance imaging. Tumors were mapped on magnetic resonance imaging and histopathology. Sensitivity, specificity, positive predictive value and negative predictive value of magnetic resonance imaging for cancer detection were calculated. In addition, the effects of tumor size and Gleason score on the sensitivity of multiparametric magnetic resonance imaging were evaluated.
  
  
  RESULTS
  The positive predictive value of multiparametric magnetic resonance imaging to detect prostate cancer was 98%, 98% and 100% in the overall prostate, peripheral zone and central gland, respectively. The sensitivity of magnetic resonance imaging sequences was higher for tumors larger than 5 mm in diameter as well as for those with higher Gleason scores (greater than 7, p <0.05).
  
  
  CONCLUSIONS
  Prostate magnetic resonance imaging at 3T allows for the detection of prostate cancer. A multiparametric approach increases the predictive power of magnetic resonance imaging for diagnosis. In this study accurate correlation between multiparametric magnetic resonance imaging and histopathology was obtained by the patient specific, magnetic resonance imaging based mold technique.
authors.affiliation: Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, USA.
authors.forename: Baris
authors.initials: B
authors.lastname: Turkbey
authors.forename: Haresh
authors.initials: H
authors.lastname: Mani
authors.forename: Vijay
authors.initials: V
authors.lastname: Shah
authors.forename: Ardeshir R
authors.initials: AR
authors.lastname: Rastinehad
authors.forename: Marcelino
authors.initials: M
authors.lastname: Bernardo
authors.forename: Thomas
authors.initials: T
authors.lastname: Pohida
authors.forename: Yuxi
authors.initials: Y
authors.lastname: Pang
authors.forename: Dagane
authors.initials: D
authors.lastname: Daar
authors.forename: Compton
authors.initials: C
authors.lastname: Benjamin
authors.forename: Yolanda L
authors.initials: YL
authors.lastname: McKinney
authors.forename: Hari
authors.initials: H
authors.lastname: Trivedi
authors.forename: Celene
authors.initials: C
authors.lastname: Chua
authors.forename: Gennady
authors.initials: G
authors.lastname: Bratslavsky
authors.forename: Joanna H
authors.initials: JH
authors.lastname: Shih
authors.forename: W Marston
authors.initials: WM
authors.lastname: Linehan
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Merino
authors.forename: Peter L
authors.initials: PL
authors.lastname: Choyke
authors.forename: Peter A
authors.initials: PA
authors.lastname: Pinto
mesh_terms: D000368:Aged; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011446:Prospective Studies; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D012669:Seminal Vesicles / Q000473:pathology; D012680:Sensitivity and Specificity