title: Multiparametric dynamic contrast-enhanced ultrasound imaging of prostate cancer.
abstract: OBJECTIVE
  The aim of this study is to improve the accuracy of dynamic contrast-enhanced ultrasound (DCE-US) for prostate cancer (PCa) localization by means of a multiparametric approach.
  
  
  METHODS
  Thirteen different parameters related to either perfusion or dispersion were extracted pixel-by-pixel from 45 DCE-US recordings in 19 patients referred for radical prostatectomy. Multiparametric maps were retrospectively produced using a Gaussian mixture model algorithm. These were subsequently evaluated on their pixel-wise performance in classifying 43 benign and 42 malignant histopathologically confirmed regions of interest, using a prostate-based leave-one-out procedure.
  
  
  RESULTS
  The combination of the spatiotemporal correlation (r), mean transit time (μ), curve skewness (κ), and peak time (PT) yielded an accuracy of 81% ± 11%, which was higher than the best performing single parameters: r (73%), μ (72%), and wash-in time (72%). The negative predictive value increased to 83% ± 16% from 70%, 69% and 67%, respectively. Pixel inclusion based on the confidence level boosted these measures to 90% with half of the pixels excluded, but without disregarding any prostate or region.
  
  
  CONCLUSIONS
  Our results suggest multiparametric DCE-US analysis might be a useful diagnostic tool for PCa, possibly supporting future targeting of biopsies or therapy. Application in other types of cancer can also be foreseen.
  
  
  CONCLUSIONS
  • DCE-US can be used to extract both perfusion and dispersion-related parameters. • Multiparametric DCE-US performs better in detecting PCa than single-parametric DCE-US. • Multiparametric DCE-US might become a useful tool for PCa localization.
authors.affiliation: Laboratory of Biomedical Diagnostics, Department of Electrical Engineering, Eindhoven University of Technology, PO-Box 513, 5600 MB, Eindhoven, The Netherlands. r.r.wildeboer@tue.nl.
authors.forename: Rogier R
authors.initials: RR
authors.lastname: Wildeboer
authors.affiliation: Department of Urology, Academic Medical Center University Hospital, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Arnoud W
authors.initials: AW
authors.lastname: Postema
authors.affiliation: Laboratory of Biomedical Diagnostics, Department of Electrical Engineering, Eindhoven University of Technology, PO-Box 513, 5600 MB, Eindhoven, The Netherlands.
authors.forename: Libertario
authors.initials: L
authors.lastname: Demi
authors.affiliation: Philips Research, Philips, Eindhoven, The Netherlands.
authors.forename: Maarten P J
authors.initials: MPJ
authors.lastname: Kuenen
authors.affiliation: Laboratory of Biomedical Diagnostics, Department of Electrical Engineering, Eindhoven University of Technology, PO-Box 513, 5600 MB, Eindhoven, The Netherlands.|Department of Urology, Academic Medical Center University Hospital, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
authors.forename: Hessel
authors.initials: H
authors.lastname: Wijkstra
authors.affiliation: Laboratory of Biomedical Diagnostics, Department of Electrical Engineering, Eindhoven University of Technology, PO-Box 513, 5600 MB, Eindhoven, The Netherlands.
authors.forename: Massimo
authors.initials: M
authors.lastname: Mischi
mesh_terms: D000368:Aged; D000465:Algorithms; D003287:Contrast Media / Q000008:administration & dosage; D055088:Early Detection of Cancer / Q000379:methods; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Classification; Contrast agents; Multiparametric imaging; Prostate cancer; Ultrasound