title: Diffusion-weighted and dynamic contrast-enhanced MRI of prostate cancer: correlation of quantitative MR parameters with Gleason score and tumor angiogenesis.
abstract: OBJECTIVE
  The objective of our study was to investigate whether quantitative parameters derived from diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI) correlate with Gleason score and angiogenesis of prostate cancer.
  
  
  METHODS
  Seventy-three patients who underwent preoperative MRI and radical prostatectomy were included in our study. A radiologist and pathologist located the dominant tumor on the MR images based on histopathologic correlation. For each dominant tumor, the apparent diffusion coefficient (ADC) value and quantitative DCE-MRI parameters (i.e., contrast agent transfer rate between blood and tissue [K(trans)], extravascular extracellular fractional volume [v(e)], contrast agent backflux rate constant [k(ep)], and blood plasma fractional volume on a voxel-by-voxel basis [v(p)]) were calculated and the Gleason score was recorded. The mean blood vessel count, mean vessel area fraction, and vascular endothelial growth factor (VEGF) expression of the dominant tumor were determined using CD31, CD34, and VEGF antibody stains. Spearman correlation analysis between MR and histopathologic parameters was conducted.
  
  
  RESULTS
  The mean tumor diameter was 15.2 mm (range, 5-28 mm). Of the 73 prostate cancer tumors, five (6.8%) had a Gleason score of 6, 46 (63%) had a Gleason score of 7, and 22 (30.1%) had a Gleason score of greater than 7. ADC values showed a moderate negative correlation with Gleason score (r = -0.376, p = 0.001) but did not correlate with tumor angiogenesis parameters. Quantitative DCE-MRI parameters did not show a significant correlation with Gleason score or VEGF expression (p > 0.05). Mean blood vessel count and mean vessel area fraction parameters estimated from prostate cancer positively correlated with k(ep) (r = 0.440 and 0.453, respectively; p = 0.001 for both).
  
  
  CONCLUSIONS
  There is a moderate correlation between ADC values and Gleason score and between k(ep) and microvessel density of prostate cancer. Although the strength of the correlations is insufficient for immediate diagnostic utility, these results warrant further investigation on the potential of multiparametric MRI to facilitate noninvasive assessment of prostate cancer aggressiveness and angiogenesis.
authors: Department of Radiology, University of Chicago, IL 60637, USA. aoto@radiology.bsd.uchicago.edu
authors: Aytekin
authors: A
authors: Oto
authors: Cheng
authors: C
authors: Yang
authors: Arda
authors: A
authors: Kayhan
authors: Maria
authors: M
authors: Tretiakova
authors: Tatjana
authors: T
authors: Antic
authors: Christine
authors: C
authors: Schmid-Tannwald
authors: Scott
authors: S
authors: Eggener
authors: Gregory S
authors: GS
authors: Karczmar
authors: Walter M
authors: WM
authors: Stadler
mesh_terms: D000368:Aged; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging; D019786:Gadolinium DTPA; D006801:Humans; D007124:Immunoenzyme Techniques; D008279:Magnetic Resonance Imaging / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000473:pathology*; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA