Characterization of clinical human prostate cancer lesions using 3.0-T sodium MRI registered to Gleason-graded whole-mount histopathology

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Journal of Magnetic Resonance Imaging





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© 2018 International Society for Magnetic Resonance in Medicine Background: Overtreatment of prostate cancer (PCa) is a healthcare issue. Development of noninvasive imaging tools for improved characterization of prostate lesions might reduce overtreatment. Purpose: To measure the distribution of tissue sodium concentration (TSC), proton T 2 -weighted signal, and apparent diffusion coefficient (ADC) values in human PCa and to test the presence of a correlation between regional differences in imaging metrics and the Gleason grade of lesions determined from histopathology. Study Type: Cross-sectional. Subjects: Ten men with biopsy-proven PCa. Sequences/Field Strength: Sodium, proton T 2 -weighted, and diffusion-weighted MRI data were acquired using Broad-Band 3D-Fast-Gradient-Recalled, 3D Cube (Isotropic 3D-Fast-Turbo-Spin-Echo acquisition) and 2D Spin-Echo sequences, respectively, with a 3.0T MR scanner. Assessment: All imaging data were coregistered to Gleason-graded postprostatectomy histology, as the standard for prostate cancer lesion characterization. Regional TSC and T 2 data were assessed using percent changes from healthy tissue of the same patient (denoted ΔTSC, ΔT 2 ). Statistics: Differences in ΔTSC, ADC, and ΔT 2 as a function of Gleason score were analyzed for each imaging contrast using a one-way analysis of variance or a nonparametric t-test. Correlations between imaging data measures and Gleason score were assessed using a Spearman's ranked correlation. Results: Evaluation of the correlation of ΔTSC, ADC, and ΔT 2 datasets with Gleason scoring revealed that only the correlation between ΔTSC and Gleason score was statistically significant (r s = 0.791, p < 0.01), whereas the correlations of ADC and ΔT 2 with Gleason score were not (r s = –0.306, p = 0.079 and r s = –0.069, p = 0.699, respectively). In addition, all individual patients showed monotonically increasing ΔTSC with Gleason score. Data Conclusion: The results of this preliminary study suggest that changes in TSC, assessed by sodium MRI, has utility as a noninvasive imaging assay to accurately characterize PCa lesions. Sodium MRI may provide useful complementary information on mpMRI, which may assist the decision-making of men choosing either active surveillance or treatment. Level of Evidence: 1. Technical Efficacy: Stage 2. J. Magn. Reson. Imaging 2019;49:1409–1419.

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