A Blinding Comparative Study of Multiparametric Magnetic Resonance Imaging in Diagnosing Prostate Cancer_West China Medical Journal

Authors：

 PengTao ¹ , XiongYan ¹ , XiaoJianming ¹ , YangJin ²

1. Department of Radiology, Affiliated Hospital of Chengdu University, Chengdu, Sichuan 610106, P. R. China;
2. Department of Urinary Surgery;Affiliated Hospital of Chengdu University, Chengdu, Sichuan 610106, P. R. China;

Corresponding author：

Keywords：

Magnetic resonance imaging; Magnetic resonance Spectrum; Diffusion weighted imaging; Apparent diffusion coefficient; Dynamic enhancement; Prostate cancer

DOI：

10.7507/1002-0179.20160023

Video：

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Objective To compare the effectiveness of T2 weighted image (T2WI) and some compounded MRI techniques, including T2WI combined with magnetic resonance spectroscopy (T2WI+MRS), T2WI combined with diffusion weighted imaging (T2WI+DWI) and T2WI combined with dynamic contrast-enhancement [T2WI+(DCE-MRI)] respectively, with 1.5 T MR scanner in diagnosing prostate cancer through a blinding method. Methods Between March 2011 and April 2013, two observers diagnosed 59 cases with a blinding method. The research direction of radiologist A was to diagnose prostate cancer. The observers diagnosed and scored the cases with T2WI, T2WI+(DCE-MRI), T2WI+MRS, T2WI+DWI and compositive method respectively. The data were statistically analyzed with receiver operating characteristic (ROC) curve. Results According to the ROC curve, both observers got the sequence of area under curve (AUC) as T2WI+DWI > T2WI+(DCE-MRI) > T2WI+MRS > T2WI. On the basis of the result from observer A, the AUC from each technique was similar. The AUC of T2+DWI was slightly bigger than others. The specificity of single T2WI was the lowest; the sensitivity of T2WI was slightly higher. The AUC of the compositive method was marginally larger than T2WI+DWI. According to the result from observer B, the AUC of T2WI+DWI was obviously larger than the others. The AUC of single T2WI was much smaller than the other techniques. The single T2WI method had the lowest sensitivity and the highest specificity. The AUC of T2WI+DWI was slightly larger than the compositive method. The AUC of T2WI+(DCE-MRI), T2WI+MRS, single T2WI methods from observer A was obviously higher than those from the score of observer B. The AUC of T2WI+DWI from the two observers was similar. Conclusion The method of combined T2WI and functional imaging sequences can improve the diagnosing specificity when a 1.5 T MR scanner is used. T2WI+DWI is the best method in diagnosing prostate cancer with least influence from the experience of observers in this research. The compositive method can improve the diagnosis of prostate cancer effectively, but when there are contradictions between different methods, the T2WI+DWI should be considered as a key factor.

Citation： PengTao, XiongYan, XiaoJianming, YangJin. A Blinding Comparative Study of Multiparametric Magnetic Resonance Imaging in Diagnosing Prostate Cancer. West China Medical Journal, 2016, 31(1): 88-93. doi: 10.7507/1002-0179.20160023 Copy

1.	Ren J, Yang Y, Zhang J, et al. T(2)-weighted combined with diffusion-weighted images for evaluating prostatic transition zone tumors at 3 Tesla[J]. Future Oncol, 2013, 9(4):585-593.
2.	Maas MC, Fütterer JJ, Scheenen TW. Quantitative evaluation of computed high B value diffusion-weighted magnetic resonance imaging of the prostate[J]. Invest Radiol, 2013, 48(11):779-786.
3.	可赞, 邓明, 王良. 基于PI-RADS多参数MRI诊断移行带前列腺癌的研究进展[J]. 放射学实践, 2015, 30(8):880-884.
4.	李飞宇, 王霄英, 肖江喜, 等. 中国男性前列腺癌MRS体素诊断标准[J]. 中国医学影像技术, 2009, 25(5):833-836.
5.	Macura KJ. Multiparametric magnetic resonance imaging of the prostate:current status in prostate cancer detection, localization, and staging[J]. Semin Roentgenol, 2008, 43(4):303-313.
6.	Jacobs MA, Pan L, Macura KJ. Whole-body diffusion-weighted and proton imaging:a review of this emerging technology for monitoring metastatic cancer[J]. Semin Roentgenol, 2009, 44(2):111-122.
7.	Jacobs MA, Ouwerkerk R, Kamel L, et al. Proton, diffusion-weighted imaging, and sodium (²³Na) MRI of uterine leiomyomata after MR-guided high-intensity focused ultrasound:a preliminary study[J]. J Magn Reson Imaging, 2009, 29(3):649-656.
8.	Desouza NM, Reinsberg SA, Scurr ED, et al. Magnetic resonance imaging in prostate cancer:the value of apparent diffusion coefficients for identifying malignant nodules[J]. Br J Radiol, 2007, 80(950):90-95.
9.	Kim CK, Choi D, Park BK, et al. Diffusion-weighted Mr imaging for the evaluation of seminal vesicle invasion in prostate cancer:initial results[J]. J Magn Reson Imaging, 2008, 28(4):963-969.
10.	Ren J, Huan Y, Wang H, et al. Seminal vesicle invasion in prostate cancer:prediction with combined T2-weighted and diffusion-weighted Mr imaging[J]. Eur Radiol, 2009, 19(10):2481-2486.
11.	吴道清, 陈自谦, 聂玫, 等. 3.0T MRS对前列腺外周带癌的诊断价值及其与PSA相关性研究[J]. 临床放射学杂志, 2010, 29(7): 918-922.
12.	Shah N, Sattar A, Benanti M, et al. Magnetic resonance spectroscopy as an imaging tool for cancer:a review of the literature[J]. J Am Osteopath Assoc, 2006, 106(1):23-27.
13.	Kim JK, Hong SS, Choi YJ, et al. Wash-in rate on the basis of dynamic contrast-enhanced MRI:usefulness for prostate cancer detection and localization[J]. J Magn Reson Imaging, 2005, 22(5):639-646.
14.	Engelbrecht MR, Huisman HJ, Laheij RJ, et al. Discrimination of prostate cancer from normal peripheral zone and central gland tissue by using dynamic contrast-enhanced Mr imaging[J]. Radiology, 2003, 229(1):248-254.
15.	Erbersdobler A, Isbarn H, Dix K, et al. Prognostic value of microvessel density in prostate cancer:a tissue microarray study[J]. World J Urol, 2010, 28(6):687-692.
16.	Mucci LA, Powolny A, Giovannucci E, et al. Prospective study of prostate tumor angiogenesis and cancer-specific mortality in the health professionals follow-up study[J]. J Clin Oncol, 2009, 27(33):5627-5633.

1. Ren J, Yang Y, Zhang J, et al. T(2)-weighted combined with diffusion-weighted images for evaluating prostatic transition zone tumors at 3 Tesla[J]. Future Oncol, 2013, 9(4):585-593.
2. Maas MC, Fütterer JJ, Scheenen TW. Quantitative evaluation of computed high B value diffusion-weighted magnetic resonance imaging of the prostate[J]. Invest Radiol, 2013, 48(11):779-786.
3. 可赞, 邓明, 王良. 基于PI-RADS多参数MRI诊断移行带前列腺癌的研究进展[J]. 放射学实践, 2015, 30(8):880-884.
4. 李飞宇, 王霄英, 肖江喜, 等. 中国男性前列腺癌MRS体素诊断标准[J]. 中国医学影像技术, 2009, 25(5):833-836.
5. Macura KJ. Multiparametric magnetic resonance imaging of the prostate:current status in prostate cancer detection, localization, and staging[J]. Semin Roentgenol, 2008, 43(4):303-313.
6. Jacobs MA, Pan L, Macura KJ. Whole-body diffusion-weighted and proton imaging:a review of this emerging technology for monitoring metastatic cancer[J]. Semin Roentgenol, 2009, 44(2):111-122.
7. Jacobs MA, Ouwerkerk R, Kamel L, et al. Proton, diffusion-weighted imaging, and sodium (²³Na) MRI of uterine leiomyomata after MR-guided high-intensity focused ultrasound:a preliminary study[J]. J Magn Reson Imaging, 2009, 29(3):649-656.
8. Desouza NM, Reinsberg SA, Scurr ED, et al. Magnetic resonance imaging in prostate cancer:the value of apparent diffusion coefficients for identifying malignant nodules[J]. Br J Radiol, 2007, 80(950):90-95.
9. Kim CK, Choi D, Park BK, et al. Diffusion-weighted Mr imaging for the evaluation of seminal vesicle invasion in prostate cancer:initial results[J]. J Magn Reson Imaging, 2008, 28(4):963-969.
10. Ren J, Huan Y, Wang H, et al. Seminal vesicle invasion in prostate cancer:prediction with combined T2-weighted and diffusion-weighted Mr imaging[J]. Eur Radiol, 2009, 19(10):2481-2486.
11. 吴道清, 陈自谦, 聂玫, 等. 3.0T MRS对前列腺外周带癌的诊断价值及其与PSA相关性研究[J]. 临床放射学杂志, 2010, 29(7): 918-922.
12. Shah N, Sattar A, Benanti M, et al. Magnetic resonance spectroscopy as an imaging tool for cancer:a review of the literature[J]. J Am Osteopath Assoc, 2006, 106(1):23-27.
13. Kim JK, Hong SS, Choi YJ, et al. Wash-in rate on the basis of dynamic contrast-enhanced MRI:usefulness for prostate cancer detection and localization[J]. J Magn Reson Imaging, 2005, 22(5):639-646.
14. Engelbrecht MR, Huisman HJ, Laheij RJ, et al. Discrimination of prostate cancer from normal peripheral zone and central gland tissue by using dynamic contrast-enhanced Mr imaging[J]. Radiology, 2003, 229(1):248-254.
15. Erbersdobler A, Isbarn H, Dix K, et al. Prognostic value of microvessel density in prostate cancer:a tissue microarray study[J]. World J Urol, 2010, 28(6):687-692.
16. Mucci LA, Powolny A, Giovannucci E, et al. Prospective study of prostate tumor angiogenesis and cancer-specific mortality in the health professionals follow-up study[J]. J Clin Oncol, 2009, 27(33):5627-5633.

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West China Medical Journal

A Blinding Comparative Study of Multiparametric Magnetic Resonance Imaging in Diagnosing Prostate Cancer

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