Faculty Collaboration Database

Revisiting quantitative multi-parametric MRI of benign prostatic hyperplasia and its differentiation from transition zone cancer. Abdom Radiol (NY) 2019 Jun;44(6):2233-2243

Date

04/08/2019

Pubmed ID

30955071

DOI

10.1007/s00261-019-01936-1

Scopus ID

2-s2.0-85064479088 (requires institutional sign-in at Scopus site)   29 Citations

Abstract

PURPOSE: This study investigates the multiparametric MRI (mpMRI) appearance of different types of benign prostatic hyperplasia (BPH) and whether quantitative mpMRI is effective in differentiating between prostate cancer (PCa) and BPH.

MATERIALS AND METHODS: Patients (n = 60) with confirmed PCa underwent preoperative 3T MRI. T2-weighted, multi-echo T2-weighted, diffusion weighted and dynamic contrast enhanced images (DCE) were obtained prior to undergoing prostatectomy. PCa and BPH (cystic, glandular or stromal) were identified in the transition zone and matched with MRI. Quantitative mpMRI metrics: T2, ADC and DCE-MRI parameters using an empirical mathematical model were measured.

RESULTS: ADC values were significantly lower (p < 0.001) in PCa compared to all BPH types and can differentiate between PCa and BPH with high accuracy (AUC = 0.87, p < 0.001). T2 values were significantly lower (p < 0.001) in PCa compared to cystic BPH only, while glandular (p = 0.27) and stromal BPH (p = 0.99) showed no significant difference from PCa. BPH mimics PCa in the transition zone on DCE-MRI evidenced by no significant difference between them. mpMRI values of glandular (ADC = 1.31 ± 0.22 µm²/ms, T2 = 115.7 ± 37.3 ms) and cystic BPH (ADC = 1.92 ± 0.43 µm²/ms, T2 = 242.8 ± 117.9 ms) are significantly different. There was no significant difference in ADC (p = 0.72) and T2 (p = 0.46) between glandular and stromal BPH.

CONCLUSIONS: Multiparametric MRI and specifically quantitative ADC values can be used for differentiating PCa and BPH, improving PCa diagnosis in the transition zone. However, DCE-MRI metrics are not effective in distinguishing PCa and BPH. Glandular BPH are not hyperintense on ADC and T2 as previously thought and have similar quantitative mpMRI measurements to stromal BPH. Glandular and cystic BPH appear differently on mpMRI and are histologically different.

Author List

Chatterjee A, Gallan AJ, He D, Fan X, Mustafi D, Yousuf A, Antic T, Karczmar GS, Oto A

Author

Alexander J. Gallan MD Assistant Professor in the Pathology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Contrast Media
Diagnosis, Differential
Diffusion Magnetic Resonance Imaging
Humans
Magnetic Resonance Imaging
Male
Middle Aged
Prostatectomy
Prostatic Hyperplasia
Prostatic Neoplasms
Retrospective Studies