title: DCE-MRI of the prostate using shutter-speed vs. Tofts model for tumor characterization and assessment of aggressiveness.
abstract: To quantify Tofts model (TM) and shutter-speed model (SSM) perfusion parameters in prostate cancer (PCa) and noncancerous peripheral zone (PZ) and to compare the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to Prostate Imaging and Reporting and Data System (PI-RADS) classification for the assessment of PCa aggressiveness.
  
  
  
  Fifty PCa patients (mean age 60 years old) who underwent MRI at 3.0T followed by prostatectomy were included in this Institutional Review Board-approved retrospective study. DCE-MRI parameters (Ktrans, ve, kep[TM&SSM] and intracellular water molecule lifetime τi[SSM]) were determined in PCa and PZ. Differences in DCE-MRI parameters between PCa and PZ, and between models were assessed using Wilcoxon signed-rank tests. Receiver operating characteristic (ROC) analysis for differentiation between PCa and PZ was performed for individual and combined DCE-MRI parameters. Diagnostic performance of DCE-MRI parameters for identification of aggressive PCa (Gleason ≥8, grade group [GG] ≥3 or pathology stage pT3) was assessed using ROC analysis and compared with PI-RADSv2 scores.
  
  
  
  DCE-MRI parameters were significantly different between TM and SSM and between PZ and PCa (P < 0.037). Diagnostic performances of TM and SSM for differentiation of PCa from PZ were similar (highest AUC TM: Ktrans+kep0.76, SSM: τi+kep0.80). PI-RADS outperformed TM and SSM DCE-MRI for identification of Gleason ≥8 lesions (AUC PI-RADS: 0.91, highest AUC DCE-MRI: Ktrans+τiSSM 0.61, P = 0.002). The diagnostic performance of PI-RADS and DCE-MRI for identification of GG ≥3 and pT3 PCa was not significantly different (P > 0.213).
  
  
  
  SSM DCE-MRI did not increase the diagnostic performance of DCE-MRI for PCa characterization. PI-RADS outperformed both TM and SSM DCE-MRI for identification of aggressive cancer.
  
  
  
  3 Technical Efficacy: Stage 2 J. MAGN. RESON. IMAGING 2017;46:837-849.
authors.affiliation: Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Stefanie J
authors.initials: SJ
authors.lastname: Hectors
authors.affiliation: Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.|Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Besa
authors.affiliation: Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Mathilde
authors.initials: M
authors.lastname: Wagner
authors.affiliation: Applied Mathematics and Modeling, Scientific Informatics Department, Merck Sharp & Dohme, Boston, Massachusetts, USA.
authors.forename: Guido H
authors.initials: GH
authors.lastname: Jajamovich
authors.affiliation: Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: George K
authors.initials: GK
authors.lastname: Haines
authors.affiliation: Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.|Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Sara
authors.initials: S
authors.lastname: Lewis
authors.affiliation: Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Tewari
authors.affiliation: Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Ardeshir
authors.initials: A
authors.lastname: Rastinehad
authors.affiliation: Advanced Imaging Research Center, Oregon Health & Science University, Portland, Oregon, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Huang
authors.affiliation: Translational and Molecular Imaging Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA.|Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Bachir
authors.initials: B
authors.lastname: Taouli
mesh_terms: D003287:Contrast Media; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D015203:Reproducibility of Results; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media
keywords: DCE-MRI; Tofts; prostate cancer; shutter-speed