"Textural analysis of multiparametric MRI detects transition zone prostate cancer".
OBJECTIVE
To evaluate multiparametric-MRI (mpMRI) derived histogram textural-analysis parameters for detection of transition zone (TZ) prostatic tumour.


METHODS
Sixty-seven consecutive men with suspected prostate cancer underwent 1.5T mpMRI prior to template-mapping-biopsy (TPM). Twenty-six men had 'significant' TZ tumour. Two radiologists in consensus matched TPM to the single axial slice best depicting tumour, or largest TZ diameter for those with benign histology, to define single-slice whole TZ-regions-of-interest (ROIs). Textural-parameter differences between single-slice whole TZ-ROI containing significant tumour versus benign/insignificant tumour were analysed using Mann Whitney U test. Diagnostic accuracy was assessed by receiver operating characteristic area under curve (ROC-AUC) analysis cross-validated with leave-one-out (LOO) analysis.


RESULTS
ADC kurtosis was significantly lower (p < 0.001) in TZ containing significant tumour with ROC-AUC 0.80 (LOO-AUC 0.78); the difference became non-significant following exclusion of significant tumour from single-slice whole TZ-ROI (p = 0.23). T1-entropy was significantly lower (p = 0.004) in TZ containing significant tumour with ROC-AUC 0.70 (LOO-AUC 0.66) and was unaffected by excluding significant tumour from TZ-ROI (p = 0.004). Combining these parameters yielded ROC-AUC 0.86 (LOO-AUC 0.83).


CONCLUSIONS
Textural features of the whole prostate TZ can discriminate significant prostatic cancer through reduced kurtosis of the ADC-histogram where significant tumour is included in TZ-ROI and reduced T1 entropy independent of tumour inclusion.


CONCLUSIONS
• MR textural features of prostate transition zone may discriminate significant prostatic cancer. • Transition zone (TZ) containing significant tumour demonstrates a less peaked ADC histogram. • TZ containing significant tumour reveals higher post-contrast T1-weighted homogeneity. • The utility of MR texture analysis in prostate cancer merits further investigation.
Centre for Medical Imaging, University College London, 3rd Floor East, 250 Euston Road, London, NW1 2BU, UK.|University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK.
Harbir S
HS
Sidhu
Centre for Medical Imaging, University College London, 3rd Floor East, 250 Euston Road, London, NW1 2BU, UK.
Salvatore
S
Benigno
Institute of Nuclear Medicine, University College London, University College Hospital, 235 Euston Road, London, NW1 2BU, UK.
Balaji
B
Ganeshan
Centre for Medical Imaging, University College London, 3rd Floor East, 250 Euston Road, London, NW1 2BU, UK.
Nikos
N
Dikaios
Centre for Medical Imaging, University College London, 3rd Floor East, 250 Euston Road, London, NW1 2BU, UK.|University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK.
Edward W
EW
Johnston
University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK.
Clare
C
Allen
University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK.
Alex
A
Kirkham
University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK.|Institute of Nuclear Medicine, University College London, University College Hospital, 235 Euston Road, London, NW1 2BU, UK.
Ashley M
AM
Groves
University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK.|Research Department of Urology, University College London, 3rd Floor, Charles Bell House 67 Riding House Street, London, W1P 7NN, UK.
Hashim U
HU
Ahmed
University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK.|Research Department of Urology, University College London, 3rd Floor, Charles Bell House 67 Riding House Street, London, W1P 7NN, UK.
Mark
M
Emberton
Centre for Medical Imaging, University College London, 3rd Floor East, 250 Euston Road, London, NW1 2BU, UK.|University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK.
Stuart A
SA
Taylor
Centre for Medical Imaging, University College London, 3rd Floor East, 250 Euston Road, London, NW1 2BU, UK.|University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK.
Steve
S
Halligan
Centre for Medical Imaging, University College London, 3rd Floor East, 250 Euston Road, London, NW1 2BU, UK. shonit.punwani@gmail.com.|University College London Hospitals NHS Foundation Trust, 235 Euston Road, London, NW1 2BU, UK. shonit.punwani@gmail.com.|Centre for Medical Imaging, University College London and University College London Hospitals NIHR Biomedical Research Centre, 250 Euston Road, London, NW1 2BU, UK. shonit.punwani@gmail.com.
Shonit
S
Punwani
D000368:Aged; D019540:Area Under Curve; D001706:Biopsy / Q000379:methods; D032921:Consensus; D038524:Diffusion Magnetic Resonance Imaging; D019277:Entropy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D012372:ROC Curve; D012189:Retrospective Studies
Cancer; Diagnosis; Image Processing; Magnetic Resonance Imaging; Prostate