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. 2023 Jun 23;18(6):e0287651.
doi: 10.1371/journal.pone.0287651. eCollection 2023.

Optimal length and temporal resolution of dynamic contrast-enhanced MR imaging for the differentiation between prostate cancer and normal peripheral zone tissue

Marius Hellstern  1 , Carlos Martinez  2 , Christopher Wallenhorst  2 , Dirk Beyersdorff  3 , Lutz Lüdemann  4 , Marc-Oliver Grimm  5 , Ulf Teichgräber  6 , Tobias Franiel  6
Affiliations

Optimal length and temporal resolution of dynamic contrast-enhanced MR imaging for the differentiation between prostate cancer and normal peripheral zone tissue

Marius Hellstern et al. PLoS One. .

Erratum in

Abstract

The value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in the detection of prostate cancer is controversial. There are currently insufficient peer reviewed published data or expert consensus to support routine adoption of DCE-MRI for clinical use. Thus, the objective of this study was to explore the optimal temporal resolution and measurement length for DCE-MRI to differentiate cancerous from normal prostate tissue of the peripheral zone of the prostate by non-parametric MRI analysis and to compare with a quantitative MRI analysis. Predictors of interest were onset time, relative signal intensity (RSI), wash-in slope, peak enhancement, wash-out and wash-out slope determined from non-parametric characterisation of DCE-MRI intensity-time profiles. The discriminatory power was estimated from C-statistics based on cross validation. We analyzed 54 patients with 97 prostate tissue specimens (47 prostate cancer, 50 normal prostate tissue) of the peripheral zone, mean age 63.8 years, mean prostate-specific antigen 18.9 ng/mL and mean of 10.5 days between MRI and total prostatectomy. When comparing prostate cancer tissue with normal prostate tissue, median RSI was 422% vs 330%, and wash-in slope 0.870 vs 0.539. The peak enhancement of 67 vs 42 was higher with prostate cancer tissue, while wash-out (-30% vs -23%) and wash-out slope (-0.037 vs -0.029) were lower, and the onset time (32 seconds) was comparable. The optimal C-statistics was 0.743 for temporal resolution of 8.0 seconds and measurement length of 2.5 minutes compared with 0.656 derived from a quantitative MRI analysis. This study provides evidence that the use of a non-parametric approach instead of a more established parametric approach resulted in greater precision to differentiate cancerous from normal prostate tissue of the peripheral zone of the prostate.

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Conflict of interest statement

Marius Hellstern has nothing to disclose. Christopher Wallenhorst and Carlos Martinez are employees of the Institute for Epidemiology, Statistics and Informatics GmbH. The Institute for Epidemiology, Statistics and Informatics GmbH has received grants from Bayer, Bristol-Myers Squibb and CSL Behring outside the submitted work. Marc-Oliver Grimm and Ulf Teichgräber have nothing to disclose. Tobias Franiel receives financial support from Zentrales Innovationsprogramm Mittelstand des Bundesministeriums für Wirtschaft und Energie (ZF4816001BA9), personal fees from Bayer AG, Medac GmbH and Saegeling Medizintechnik GmbH and royalties from Georg Thieme Verlag. Tobias Franiel serves on the advisory board of Bayer AG and is a member of the committee of German S3 guideline for prostate cancer. Dirk Beyersdorff has nothing to disclose. Lutz Lüdemann has nothing to disclose. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Flowchart for inclusion and exclusion for patient and tissue selection.
DCE-MRI: dynamic contrast-enhanced MRI.
Fig 2
Fig 2. Distribution of parameters from the raw data.
RSI: relative signal intensity.
See this image and copyright information in PMC

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