title: Evaluating Prostate Cancer Using Fractional Tissue Composition of Radical Prostatectomy Specimens and Pre-Operative Diffusional Kurtosis Magnetic Resonance Imaging.
abstract: BACKGROUND
  Evaluating tissue heterogeneity using non-invasive imaging could potentially improve prostate cancer assessment and treatment.
  
  
  METHODS
  20 patients with intermediate/high-risk prostate cancer underwent diffusion kurtosis imaging, including calculation of apparent diffusion (Dapp) and kurtosis (Kapp), prior to radical prostatectomy. Whole-mount tissue composition was quantified into: cellularity, luminal space, and fibromuscular stroma. Peripheral zone tumors were subdivided according to Gleason score.
  
  
  RESULTS
  Peripheral zone tumors had increased cellularity (p<0.0001), decreased fibromuscular stroma (p<0.05) and decreased luminal space (p<0.0001). Gleason score ≥4+3 tumors had significantly increased cellularity and decreased fibromuscular stroma compared to Gleason score ≤3+4 (p<0.05). In tumors, there was a significant positive correlation between median Kapp and cellularity (ρ = 0.50; p<0.05), and a negative correlation with fibromuscular stroma (ρ = -0.45; p<0.05). In normal tissue, median Dapp had a significant positive correlation with luminal space (ρ = 0.65; p<0.05) and a negative correlation with cellularity (ρ = -0.49; p<0.05). Median Kapp and Dapp varied significantly between tumor and normal tissue (p<0.0001), but only median Kapp was significantly different between Gleason score ≥4+3 and ≤3+4 (p<0.05).
  
  
  CONCLUSIONS
  Peripheral zone tumors have increased cellular heterogeneity which is reflected in mean Kapp, while normal prostate has a more homogeneous luminal space and cellularity better represented by Dapp.
authors.affiliation: Department of Radiology, University of Cambridge, Addenbrooke's hospital, Cambridge, United Kingdom.|Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, United States of America.
authors.forename: Edward M
authors.initials: EM
authors.lastname: Lawrence
authors.affiliation: Department of Histopathology, University of Cambridge, Addenbrooke's hospital, Cambridge, United Kingdom.
authors.forename: Anne Y
authors.initials: AY
authors.lastname: Warren
authors.affiliation: Department of Radiology, University of Cambridge, Addenbrooke's hospital, Cambridge, United Kingdom.
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Priest
authors.affiliation: Department of Radiology, University of Cambridge, Addenbrooke's hospital, Cambridge, United Kingdom.
authors.forename: Tristan
authors.initials: T
authors.lastname: Barrett
authors.affiliation: Department of Epidemiology & Biostatistics, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, United States of America.
authors.forename: Debra A
authors.initials: DA
authors.lastname: Goldman
authors.affiliation: Department of Radiology, University of Cambridge, Addenbrooke's hospital, Cambridge, United Kingdom.
authors.forename: Andrew B
authors.initials: AB
authors.lastname: Gill
authors.affiliation: Department of Urology, University of Cambridge, Addenbrooke's hospital, Cambridge, United Kingdom.
authors.forename: Vincent J
authors.initials: VJ
authors.lastname: Gnanapragasam
authors.affiliation: Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, United States of America.
authors.forename: Evis
authors.initials: E
authors.lastname: Sala
authors.affiliation: Department of Radiology, University of Cambridge, Addenbrooke's hospital, Cambridge, United Kingdom.
authors.forename: Ferdia A
authors.initials: FA
authors.lastname: Gallagher
mesh_terms: D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D011468:Prostatectomy / Q000379:methods*; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*