title: Detection of locally radio-recurrent prostate cancer at multiparametric MRI: Can dynamic contrast-enhanced imaging be omitted?
abstract: OBJECTIVE
  The goal of this study was to assess the added value of dynamic contrast-enhanced (DCE) imaging in detecting locally radio-recurrent prostate cancer using multiparametric magnetic resonance imaging (mpMRI) at 3Tesla (T).
  
  
  METHODS
  We retrospectively analyzed 45 patients with rising prostate-specific antigen level after prostate radiotherapy who underwent mpMRI [T2-weighted (T2w), diffusion-weighted (Dw) and DCE imaging] at 3T before prostate biopsy. Four readers assigned a 5-level Likert score of cancer likelihood in 8 prostate sectors (6 sextants, 2 seminal vesicles) on T2w+Dw and T2w+Dw+DCE images. Biopsy results were used as the standard of reference.
  
  
  RESULTS
  T2w+Dw and T2w+Dw+DCE imaging had similar areas under the receiver operating characteristic curves on per-sector (0.87-0.89 vs. 0.87-0.89; P=0.19-0.78) and per-lobe (0.82-0.94 vs. 0.80-0.91; P=0.21-0.84) analysis. Using a Likert score≥2/5 for diagnosis threshold, T2w+Dw+DCE imaging showed non-significantly higher sensitivities on per-sector (0.56-0.72 vs. 0.52-0.73, P=0.34-0.69) and per-lobe (0.80-0.90 vs. 0.73-0.88; P=0.63-0.99) analysis. It also showed non-significantly lower specificities on per-sector (0.74-0.89 vs. 0.82-0.89; P=0.09-0.99) and per-lobe (0.48-0.81 vs. 0.61-0.84; P=0.10-0.99) analysis. Weighted kappa values were respectively 0.57-0.70 and 0.55-0.66 for T2w+Dw and T2w+Dw+DCE imaging at the sector level, and 0.66-0.83 and 0.58-0.85 at the lobe level.
  
  
  CONCLUSIONS
  The use of DCE MR imaging tends to increase sensitivity and decrease specificity for all readers, but the differences are not significant.
authors.affiliation: Department of urinary and vascular radiology, hôpital Édouard-Herriot, hospices civils de Lyon, Lyon 69437, France.
authors.forename: F
authors.initials: F
authors.lastname: Alonzo
authors.affiliation: Laboratoire d'écologie Alpine, université Joseph-Fourier, BP 53, Grenoble 38041, France; CNRS, UMR 5553, BP 53, Grenoble 38041, France.
authors.forename: C
authors.initials: C
authors.lastname: Melodelima
authors.affiliation: Department of urinary and vascular radiology, hôpital Édouard-Herriot, hospices civils de Lyon, Lyon 69437, France; Université de Lyon, Lyon 69003, France; Faculté de médecine Lyon Est, université Lyon 1, Lyon 69003, France; Inserm, U1032, LabTau, Lyon 69003, France.
authors.forename: F
authors.initials: F
authors.lastname: Bratan
authors.affiliation: Service d'imagerie, hôpital d'instruction des armées Desgenettes, Lyon 69275, France.
authors.forename: T
authors.initials: T
authors.lastname: Vitry
authors.affiliation: Université de Lyon, Lyon 69003, France; Faculté de médecine Lyon Est, université Lyon 1, Lyon 69003, France; Inserm, U1032, LabTau, Lyon 69003, France; Department of urology, hôpital Edouard-Herriot, hospices civils de Lyon, Lyon 69437, France.
authors.forename: S
authors.initials: S
authors.lastname: Crouzet
authors.affiliation: Université de Lyon, Lyon 69003, France; Faculté de médecine Lyon Est, université Lyon 1, Lyon 69003, France; Inserm, U1032, LabTau, Lyon 69003, France; Department of urology, hôpital Edouard-Herriot, hospices civils de Lyon, Lyon 69437, France.
authors.forename: A
authors.initials: A
authors.lastname: Gelet
authors.affiliation: Department of urinary and vascular radiology, hôpital Édouard-Herriot, hospices civils de Lyon, Lyon 69437, France; Université de Lyon, Lyon 69003, France; Faculté de médecine Lyon Est, université Lyon 1, Lyon 69003, France; Inserm, U1032, LabTau, Lyon 69003, France. Electronic address: Olivier.rouviere@netcourrier.com.
authors.forename: O
authors.initials: O
authors.lastname: Rouvière
mesh_terms: D000368:Aged; D003287:Contrast Media; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging*; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media
keywords: Dynamic contrast-enhanced MRI; Multiparametric MRI; Neoplasm recurrence; Prostatic neoplasms; Radiotherapy