Dynamic contrast-enhanced MR imaging features of the normal central zone of the prostate.
OBJECTIVE
Evaluate qualitative dynamic contrast-enhanced magnetic resonance imaging (MRI) characteristics of normal central zone based on recently described central zone MRI features.


METHODS
Institutional review board-approved, Health Insurance Portability and Accountability Act compliant study, 59 patients with prostate cancer, histopathology proven to not involve central zone or prostate base, underwent endorectal MRI before prostatectomy. Two readers independently reviewed T2-weighted images and apparent diffusion coefficient (ADC) maps identifying normal central zone based on low signal intensity and location. Next, two readers drew bilateral central zone regions of interest on dynamic contrast-enhanced magnetic resonance images in consensus and independently recorded enhancement curve types as type 1 (progressive), type 2 (plateau), and type 3 (wash-out). Identification rates of normal central zone and enhancement curve type were recorded and compared for each reviewer. The institutional review board waiver was approved and granted 05/2010.


RESULTS
Central zone identified in 92%-93% of patients on T2-weighted images and 78%-88% on ADC maps without significant difference between identification rates (P = .63 and P = .15 and inter-reader agreement (κ) is 0.64 and 0.29, for T2-weighted images and ADC maps, respectively). All central zones were rated either curve type 1 or curve type 2 by both radiologists. No statistically significant difference between the two radiologists (P = .19) and inter-reader agreement was κ = 0.37.


CONCLUSIONS
Normal central zone demonstrates either type 1 (progressive) or type 2 (plateau) enhancement curves on dynamic contrast-enhanced MRI that can be potentially useful to differentiate central zone from prostate cancer that classically demonstrates a type 3 (wash-out) enhancement curve.
Department of Radiology, University of Chicago Medicine, 5841 South Maryland Ave, MC2026, Chicago, IL 60637. Electronic address: barry.hansford@uchospitals.edu.
Barry G
BG
Hansford
Department of Radiology, University of Chicago Medicine, 5841 South Maryland Ave, MC2026, Chicago, IL 60637.
Ibrahim
I
Karademir
Department of Radiology, University of Chicago Medicine, 5841 South Maryland Ave, MC2026, Chicago, IL 60637.
Yahui
Y
Peng
Department of Radiology, University of Chicago Medicine, 5841 South Maryland Ave, MC2026, Chicago, IL 60637.
Yulei
Y
Jiang
Department of Radiology, University of Chicago Medicine, 5841 South Maryland Ave, MC2026, Chicago, IL 60637.
Gregory
G
Karczmar
Department of Radiology, University of Chicago Medicine, 5841 South Maryland Ave, MC2026, Chicago, IL 60637.
Stephen
S
Thomas
Department of Radiology, University of Chicago Medicine, 5841 South Maryland Ave, MC2026, Chicago, IL 60637.
Ambereen
A
Yousuf
Department of Pathology, University of Chicago Medicine, Chicago, IL.
Tatjana
T
Antic
Department of Urology, University of Chicago Medicine, Chicago, IL.
Scott
S
Eggener
Department of Radiology, University of Chicago Medicine, 5841 South Maryland Ave, MC2026, Chicago, IL 60637.
Aytekin
A
Oto
D000328:Adult; D000368:Aged; D059925:Anatomic Landmarks / Q000473:pathology*; D003287:Contrast Media; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
D003287:Contrast Media; C064925:gadodiamide; D019786:Gadolinium DTPA
Prostate cancer; central zone; dynamic contrast-enhanced magnetic resonance imaging