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Open Access Publications from the University of California

In vivo prostate cancer detection and grading using restriction spectrum imaging-MRI.

  • Author(s): McCammack, KC
  • Kane, CJ
  • Parsons, JK
  • White, NS
  • Schenker-Ahmed, NM
  • Kuperman, JM
  • Bartsch, H
  • Desikan, RS
  • Rakow-Penner, RA
  • Adams, D
  • Liss, MA
  • Mattrey, RF
  • Bradley, WG
  • Margolis, DJA
  • Raman, SS
  • Shabaik, A
  • Dale, AM
  • Karow, DS
  • et al.

BACKGROUND:Magnetic resonance imaging (MRI) is emerging as a robust, noninvasive method for detecting and characterizing prostate cancer (PCa), but limitations remain in its ability to distinguish cancerous from non-cancerous tissue. We evaluated the performance of a novel MRI technique, restriction spectrum imaging (RSI-MRI), to quantitatively detect and grade PCa compared with current standard-of-care MRI. METHODS:In a retrospective evaluation of 33 patients with biopsy-proven PCa who underwent RSI-MRI and standard MRI before radical prostatectomy, receiver-operating characteristic (ROC) curves were performed for RSI-MRI and each quantitative MRI term, with area under the ROC curve (AUC) used to compare each term's ability to differentiate between PCa and normal prostate. Spearman rank-order correlations were performed to assess each term's ability to predict PCa grade in the radical prostatectomy specimens. RESULTS:RSI-MRI demonstrated superior differentiation of PCa from normal tissue, with AUC of 0.94 and 0.85 for RSI-MRI and conventional diffusion MRI, respectively (P=0.04). RSI-MRI also demonstrated superior performance in predicting PCa aggressiveness, with Spearman rank-order correlation coefficients of 0.53 (P=0.002) and -0.42 (P=0.01) for RSI-MRI and conventional diffusion MRI, respectively, with tumor grade. CONCLUSIONS:RSI-MRI significantly improves upon current noninvasive PCa imaging and may potentially enhance its diagnosis and characterization.

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