Document Detail

Usefulness of diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging in the diagnosis of prostate transition-zone cancer.
MedLine Citation:
PMID:  19031184     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Conventional T2-weighted (T2-WI) magnetic resonance imaging (MRI) has poor sensitivity for prostate transition-zone (TZ) cancer detection. PURPOSE: To retrospectively evaluate the clinical value of diffusion-weighted MRI (DW-MRI) and dynamic contrast-enhanced MRI (DCE-MRI) in combination with T2-WI for the diagnosis of TZ cancer. MATERIAL AND METHODS: Twenty-six TZ cancers in 23 patients with at least one tumor (tumor size >10 mm) located predominantly in the TZ were included in the study. Sixteen peripheral-zone (PZ) cancers in 12 patients with PZ cancer but without TZ cancer (control group) were selected by step-section pathologic maps. All patients underwent MRI and radical prostatectomy. MRI was obtained by a 1.5T superconducting system with a phased-array coil. Imaging sequences were T2-WI with fat saturation (FST2-WI), DW-MRI (single-shot echoplanar image, b=0 and 1000 s/mm(2), apparent diffusion coefficient [ADC] map findings), and DCE-MRI (3D fast spoiled gradient recalled [SPGR], contrast medium [0.2 mmol/kg], total injection time 5 s, image acquisition 30, 60, and 90 s). Sensitivity, specificity, accuracy, and positive predictive value (PPV) for the diagnosis of TZ cancer were evaluated in four protocols: A) FST2-WI alone, B) FST2-WI plus DW-MRI, C) FST2-WI plus DCE-MRI, D) FST2-WI plus DW-MRI plus DCE-MRI. RESULTS: Sensitivity, specificity, accuracy, and PPV in protocol A (FST2-WI alone) were 61.5%, 68.8%, 64.3%, and 76.2%, respectively. FST2-WI plus DW-MRI (protocol B) improved the sensitivity, specificity, accuracy, and PPV. In FST2-WI plus DW-MRI plus DCE-MRI (protocol D), the number of true-negative lesions increased and false-positive lesions decreased, and the sensitivity, specificity, accuracy, and PPV were 69.2%, 93.8%, 78.6%, and 94.7%, respectively. There was a significant difference between protocols A and D (P<0.05). CONCLUSION: Adding DW-MRI to FST2-WI in the diagnosis of prostate TZ cancer increased the diagnostic accuracy. The addition of DCE-MRI may be an option to improve the specificity and PPV of diagnosing TZ cancer with FST2-WI and DW-MRI.
T Yoshizako; A Wada; T Hayashi; K Uchida; M Sumura; N Uchida; H Kitagaki; M Igawa
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Acta radiologica (Stockholm, Sweden : 1987)     Volume:  49     ISSN:  1600-0455     ISO Abbreviation:  Acta Radiol     Publication Date:  2008 Dec 
Date Detail:
Created Date:  2008-11-25     Completed Date:  2008-12-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8706123     Medline TA:  Acta Radiol     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  1207-13     Citation Subset:  IM    
Department of Radiology, Shimane University Faculty of Medicine, Shimane, Japan.
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MeSH Terms
Adenocarcinoma / diagnosis*,  surgery
Aged, 80 and over
Contrast Media / diagnostic use*
Diffusion Magnetic Resonance Imaging
Gadolinium DTPA / diagnostic use
Image Enhancement / methods*
Imaging, Three-Dimensional
Magnetic Resonance Imaging / methods*
Middle Aged
Observer Variation
Predictive Value of Tests
Prostate / pathology,  surgery
Prostatic Neoplasms / diagnosis*,  surgery
Reproducibility of Results
Retrospective Studies
Sensitivity and Specificity
Reg. No./Substance:
0/Contrast Media; 80529-93-7/Gadolinium DTPA

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