title: Quantitative diffusion-weighted imaging and dynamic contrast-enhanced characterization of the index lesion with multiparametric MRI in prostate cancer patients.
abstract: To compare a simplified intravoxel incoherent motion (sIVIM) model to commonly used monoexponential and biexponential models in the characterization of prostate cancer (PCa) and noncancerous prostate tissues, and to investigate combinations of diffusion-weighted imaging (DWI) measures with dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI)-derived parameters in MRI-visible index lesions, to facilitate PCa risk stratification.
  
  
  
  In this retrospective, Institutional Review Board (IRB)-approved study, 43 consecutive patients with PCa who had 3T MRI exams followed by radical prostatectomy were included. DWI and DCE parameters were measured from one index lesion per patient, and noncancerous central gland and peripheral zone. Logistic regression modeling was performed to select the optimal combination of DWI and DCE measurements for tumor risk assessment.
  
  
  
  All diffusion models showed the lowest diffusion coefficients in tumors, intermediate values in noncancerous central gland, and highest values in noncancerous peripheral zone (all P < 0.001). Ktransand kepwere higher in tumors compared to central gland (P < 0.005) and peripheral zone (P < 0.001). The initial area under the contrast concentration curve was higher in tumor than the peripheral zone (P < 0.001). The area under the receiver operating characteristic curve of the combined DWI and DCE parameters (0.78) was higher than its individual components (0.73 and 0.63, respectively) for discriminating low- and intermediate-to-high-risk tumors.
  
  
  
  The sIVIM model provided comparable results with fewer b-values and shorter image acquisition time. The combination of DWI and DCE measurements of MRI-visible index lesions improved the preoperative prostate cancer risk characterization compared to the individual parameters from either technique alone.
  
  
  
  3 J. Magn. Reson. Imaging 2017;45:908-916.
authors.affiliation: Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Qing
authors.initials: Q
authors.lastname: Yuan
authors.affiliation: Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA.|Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Daniel N
authors.initials: DN
authors.lastname: Costa
authors.affiliation: Philips Research Laboratories, Hamburg, Germany.
authors.forename: Julien
authors.initials: J
authors.lastname: Sénégas
authors.affiliation: Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Yin
authors.initials: Y
authors.lastname: Xi
authors.affiliation: Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, Texas, USA.|Philips Research North America, Cambridge, Massachusetts, USA.
authors.forename: Andrea J
authors.initials: AJ
authors.lastname: Wiethoff
authors.affiliation: Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA.|Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Neil M
authors.initials: NM
authors.lastname: Rofsky
authors.affiliation: Department of Urology, UT Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Claus
authors.initials: C
authors.lastname: Roehrborn
authors.affiliation: Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA.|Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Lenkinski
authors.affiliation: Department of Radiology, UT Southwestern Medical Center, Dallas, Texas, USA.|Advanced Imaging Research Center, UT Southwestern Medical Center, Dallas, Texas, USA.
authors.forename: Ivan
authors.initials: I
authors.lastname: Pedrosa
mesh_terms: D000368:Aged; D003198:Computer Simulation; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D008954:Models, Biological; D009942:Organometallic Compounds; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C090600:gadobutrol
keywords: diffusion-weighted imaging; dynamic contrast-enhanced MRI; multiparametric MRI; prostate cancer