title: Dynamic contrast-enhanced case-control analysis in 3T MRI of prostate cancer can help to characterize tumor aggressiveness.
abstract: OBJECTIVE
  The aim of this work is to establish normality and tumor tissue ranges for perfusion parameters from dynamic contrast-enhanced (DCE) MR of the peripheral prostate at 3T and to compare the diagnostic performance of quantitative and semi-quantitative parameters.
  
  
  METHODS
  Thirty-six patients with prostate carcinomas (18 Gleason-6, 15 Gleason-7, and 3 Gleason-8) and 33 healthy subjects were included. Image analysis workflow comprised four steps: manual segmentation of whole prostate and lesions, series registration, voxelwise T1 mapping and calculation of pharmacokinetic and semi-quantitative parameters.
  
  
  RESULTS
  Ktrans, ve, upslope and AUC60 showed statistically significant differences between healthy peripheral areas and tumors. Curve type showed no association with healthy/tumor peripheral areas (chi-square=0.702). Areas under the ROC curves were 0.64 (95% CI: 0.54-0.75), 0.70 (0.60-0.80), 0.62 (0.51-0.72) and 0.63 (0.52-0.74) for Ktrans, ve, upslope and AUC60, respectively. The optimal cutoff values were: Ktrans=0.21min-1(sensitivity=0.61, specificity=0.64), ve=0.36 (0.63, 0.71), upslope=0.59 (0.59, 0.59) and AUC60=2.4 (0.63, 0.64). Significant differences were found between Gleason scores 6 and 7 for normalized Ktrans, upslope and AUC60, with good diagnostic accuracy (area under ROC curve 0.80, 95% CI: 0.60-1.00).
  
  
  CONCLUSIONS
  Quantitative (Ktransand ve) and semi-quantitative (upslope and AUC60) perfusion parameters showed significant differences between tumors and control areas in the peripheral prostate. Normalized Ktrans, upslope and AUC60 values might characterize tumor aggressiveness.
authors: Biomedical Engineering, Hospital Quirónsalud Valencia, Valencia, Spain; Radiology Department, Hospital Quirónsalud Valencia, Valencia, Spain; GIBI230, Instituto de Investigación Sanitaria y Hospital Universitari i Politècnic La Fe, Valencia, Spain. Electronic address: roberto.sanz@quironsalud.es.
authors: Roberto
authors: R
authors: Sanz-Requena
authors: Radiology Department, Hospital Quirónsalud Valencia, Valencia, Spain; GIBI230, Instituto de Investigación Sanitaria y Hospital Universitari i Politècnic La Fe, Valencia, Spain.
authors: Luis
authors: L
authors: Martí-Bonmatí
authors: Radiology Department, Hospital Quirónsalud Valencia, Valencia, Spain.
authors: Rosario
authors: R
authors: Pérez-Martínez
authors: Biomedical Engineering, Hospital Quirónsalud Valencia, Valencia, Spain; Radiology Department, Hospital Quirónsalud Valencia, Valencia, Spain; GIBI230, Instituto de Investigación Sanitaria y Hospital Universitari i Politècnic La Fe, Valencia, Spain; CIBER-SAM, Instituto de Salud Carlos III, Madrid, Spain.
authors: Gracián
authors: G
authors: García-Martí
mesh_terms: D019540:Area Under Curve; D016022:Case-Control Studies; D003287:Contrast Media / Q000493:pharmacokinetics*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008536:Meglumine / Q000493:pharmacokinetics*; D008875:Middle Aged; D060787:Neoplasm Grading; D009942:Organometallic Compounds / Q000493:pharmacokinetics*; D010477:Perfusion; D011237:Predictive Value of Tests; D011379:Prognosis; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine
keywords: Biomarkers; MRI; Neoplasms; Perfusion; Prostate; Standardization