title: Development of a Combined MR Fingerprinting and Diffusion Examination for Prostate Cancer.
abstract: Purpose To develop and evaluate an examination consisting of magnetic resonance (MR) fingerprinting-based T1, T2, and standard apparent diffusion coefficient (ADC) mapping for multiparametric characterization of prostate disease. Materials and Methods This institutional review board-approved, HIPAA-compliant retrospective study of prospectively collected data included 140 patients suspected of having prostate cancer. T1 and T2 mapping was performed with fast imaging with steady-state precession-based MR fingerprinting with ADC mapping. Regions of interest were drawn by two independent readers in peripheral zone lesions and normal-appearing peripheral zone (NPZ) tissue identified on clinical images. T1, T2, and ADC were recorded for each region. Histopathologic correlation was based on systematic transrectal biopsy or cognitively targeted biopsy results, if available. Generalized estimating equations logistic regression was used to assess T1, T2, and ADC in the differentiation of (a) cancer versus NPZ, (b) cancer versus prostatitis, (c) prostatitis versus NPZ, and (d) high- or intermediate-grade tumors versus low-grade tumors. Analysis was performed for all lesions and repeated in a targeted biopsy subset. Discriminating ability was evaluated by using the area under the receiver operating characteristic curve (AUC). Results In this study, 109 lesions were analyzed, including 39 with cognitively targeted sampling. T1, T2, and ADC from cancer (mean, 1628 msec ± 344, 73 msec ± 27, and 0.773 × 10-3mm2/sec ± 0.331, respectively) were significantly lower than those from NPZ (mean, 2247 msec ± 450, 169 msec ± 61, and 1.711 × 10-3mm2/sec ± 0.269) (P < .0001 for each) and together produced the best separation between these groups (AUC = 0.99). ADC and T2 together produced the highest AUC of 0.83 for separating high- or intermediate-grade tumors from low-grade cancers. T1, T2, and ADC in prostatitis (mean, 1707 msec ± 377, 79 msec ± 37, and 0.911 × 10-3mm2/sec ± 0.239) were significantly lower than those in NPZ (P < .0005 for each). Interreader agreement was excellent, with an intraclass correlation coefficient greater than 0.75 for both T1 and T2 measurements. Conclusion This study describes the development of a rapid MR fingerprinting- and diffusion-based examination for quantitative characterization of prostatic tissue.©RSNA, 2017 Online supplemental material is available for this article.
authors.affiliation: From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.
authors.forename: Alice C
authors.initials: AC
authors.lastname: Yu
authors.affiliation: From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.
authors.forename: Chaitra
authors.initials: C
authors.lastname: Badve
authors.affiliation: From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.
authors.forename: Lee E
authors.initials: LE
authors.lastname: Ponsky
authors.affiliation: From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.
authors.forename: Shivani
authors.initials: S
authors.lastname: Pahwa
authors.affiliation: From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.
authors.forename: Sara
authors.initials: S
authors.lastname: Dastmalchian
authors.affiliation: From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.
authors.forename: Matthew
authors.initials: M
authors.lastname: Rogers
authors.affiliation: From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.
authors.forename: Yun
authors.initials: Y
authors.lastname: Jiang
authors.affiliation: From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.
authors.forename: Seunghee
authors.initials: S
authors.lastname: Margevicius
authors.affiliation: From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.
authors.forename: Mark
authors.initials: M
authors.lastname: Schluchter
authors.affiliation: From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.
authors.forename: William
authors.initials: W
authors.lastname: Tabayoyong
authors.affiliation: From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.
authors.forename: Robert
authors.initials: R
authors.lastname: Abouassaly
authors.affiliation: From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.
authors.forename: Debra
authors.initials: D
authors.lastname: McGivney
authors.affiliation: From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Griswold
authors.affiliation: From the School of Medicine (A.C.Y., M.R.), Department of Radiology (C.B., S.P., S.D., M.A.G., V.G.), Department of Urology (L.E.P., W.T., R.A., V.G.), Department of Biomedical Engineering (Y.J., M.A.G., V.G.), Department of Epidemiology and Biostatistics (S.M., M.S.), and Department of Mathematics (D.M.), Case Western Reserve University, 11100 Euclid Ave, Cleveland, OH 44106.
authors.forename: Vikas
authors.initials: V
authors.lastname: Gulani
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D011472:Prostatitis / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies