Email Alert | RSS

Journal of Peking University (Health Sciences) ›› 2023, Vol. 55 ›› Issue (5): 838-842. doi: 10.19723/j.issn.1671-167X.2023.05.010

Previous Articles     Next Articles

Application of dynamic contrast enhanced status in multiparametric magnetic resonance imaging for prostatic cancer with PI-RADS 4 lesion

Chang-wei YUAN,De-run LI,Zhi-hua LI,Yi LIU,Gang-zhi SHAN,Xue-song LI*(),Li-qun ZHOU   

  1. Department of Urology, Peking University First Hospital; Institute of Urology, Peking University; National Urological Cancer Center, Beijing 100034, China
  • Received:2023-03-07 Online:2023-10-18 Published:2023-10-09
  • Contact: Xue-song LI E-mail:pineneedle@sina.com

RICH HTML

   

PDF (PC)

Abstract:

Objective: To evaluate the diagnostic value of dynamic contrast enhanced (DCE) of multiparametric magnetic resonance imaging (mpMRI) for prostate imaging reporting and data system (PI-RADS) 4 lesion in prostate peripheral zone. Methods: The clinical data of patients with PI-RADS 4 lesion in prostate peripheral zone who underwent prostate biopsy from January 2018 to September 2021 in Peking University First Hospital were retrospectively included. According to DCE status, the patients were divided into the conventional group (4 points for diffusion-weighted imaging) and the comprehensive group (3 points for diffusion-weighted imaging + 1 point for DCE positive). Pearson's chi-square test or Fisher's exact test for comparison was conducted between prostate cancer and non-cancer patients. Univariate and multivariate Logistic regression were performed to analyze the correlation of positive biopsy with age, total prostate specific antigen (PSA), free PSA/total PSA (f/tPSA), prostate volume (PV), PSA density (PSAD) and DCE status. Results: Among the 267 prostate biopsy patients, 217 cases were diagnosed as prostatic cancer (81.27%) and 50 cases were non-cancer (18.73%). Statistical analysis between the prostatic cancer group and the non-cancer group showed that there were significant differences in age, tPSA, PV and PSAD (all P < 0.05), but no significant differences in f/tPSA between the two groups. About different PI-RADS 4 lesion groups, the conventional group and the comprehensive group showed significant difference in biopsy results (P=0.001), and the conventional group had a higher positive rate. The PV of comprehensive group was larger than that of the conventional group. Among the prostate cancer patients diagnosed by biopsy, statistical analysis between the conventional group and comprehensive group showed that there were not significant differences in International Society of Urological Pathology (ISUP) grade and distinguishing clinically significant prostate cancer (all P > 0.05). Logistic univariate analysis showed that the diagnosis of prostate cancer was related to age, tPSA, f/tPSA, PV and DCE group status (all P < 0.05). Multivariate analysis showed that age, tPSA, PV and DCE group status (all P < 0.05) were independent risk factors for the diagnosis of prostatic cancer. Conclusion: tPSA, f/tPSA, PV and PSAD are the indicators to improve the diagnosis of prostatic cancer with PI-RADS 4 lesion in peripheral zone lesions. DCE status is worth considering, so that we can select patients for biopsy more accurately, reduce the rate of missed diagnosis of prostate cancer as well as avoid unnecessary prostate puncture.

Key words: Prostatic neoplasms, Magnetic resonance imaging, Dynamic contrast enhanced, Prostate imaging reporting and data system, Biopsy

CLC Number: 

  • R737.25

Table 1

Clinical characteristics of patients undergoing prostate biopsy"

Items Total (n=267) Prostate cancer group (n=217) Non-cancer group (n=50) P value
Age/years, ${\bar x}$±s 68.57±8.48 69.97±7.76 62.46±8.84 < 0.001
tPSA/(ng/mL), M (P25, P75) 9.26 (6.31, 13.23) 9.61 (6.59, 13.40) 7.23 (5.25, 12.93) 0.016
f/tPSA, ${\bar x}$±s 0.14±0.06 0.13±0.06 0.15±0.07 0.057
PV/mL, ${\bar x}$±s 53.12±33.16 48.55±28.85 72.98±42.47 < 0.001
PSAD/(ng/mL2), M (P25, P75) 0.20 (0.13, 0.36) 0.24 (0.14, 0.38) 0.12 (0.09, 0.18) < 0.001
DCE, n(%) 0.001
  Comprehensive group 117 (43.8) 85 (72.6) 32 (27.4)
  Conventional group 150 (56.2) 132 (88.0) 18 (12.0)

Table 2

The clinical and pathological characteristic of patient in comprehensive and conventional group"

Items Comprehensive group (n=117) Conventional group (n=150) P value
Age/years, ${\bar x}$±s 68.80±8.80 68.26±8.07 0.610
tPSA/(ng/mL), M (P25, P75) 9.30 (6.15, 14.29) 9.21 (6.46, 12.86) 0.923
f/tPSA, ${\bar x}$±s 0.14±0.06 0.14±0.06 0.955
PV/mL, ${\bar x}$±s 55.98±37.27 50.89±29.50 0.596
PSAD/(ng/mL2), M (P25, P75) 0.19 (0.11, 0.37) 0.20 (0.14, 0.35) 0.535

Table 3

The pathological results of prostate cancer patients in comprehensive and conventional group (n=217)"

Items Comprehensive group (n=85) Conventional group (n=132) P value
ISUP, n(%) 0.346
  1 14 (48.3) 15 (51.7)
  2 27 (34.2) 52 (65.8)
  3 15 (33.3) 30 (66.7)
  4 13 (39.4) 20 (60.6)
  5 16 (51.6) 15 (48.4)
csPCa, n(%) 0.310
   Yes 71 (37.8) 117 (62.2)
   No 14 (48.3) 15 (51.7)

Table 4

Univariate and multivariate Logistic regression analysis of predicting prostate cancer"

Items Univariate analysis Multivariate analysis
OR 95%CI P value OR 95%CI P value
Age 1.12 1.07-1.17 < 0.001 1.22 1.42-1.31 < 0.001
tPSA/(ng/mL)
  ＜4 1 1
  4-10 3.11 1.00-9.72 0.050 8.47 1.88-38.20 0.005
  >10 and ≤20 3.65 1.10-12.06 0.030 10.69 2.11-54.08 0.004
  ＞20 9.00 1.50-53.86 0.020 142.55 8.05-2 523.13 0.001
f/tPSA 0.01 0.00-0.87 0.043 0.031 0.00-71.84 0.379
PV 0.98 0.97-0.99 < 0.001 0.96 0.96-0.98 < 0.001
DCE status 0.36 0.19-0.69 0.002 0.29 0.13-0.66 0.003
1 Siegel RL , Miller KD , Jemal A . Cancer statistics, 2020[J]. CA Cancer J Clin, 2020, 70 (1): 7- 30.
doi: 10.3322/caac.21590
2 Culp MB , Soerjomataram I , Efstathiou JA , et al. Recent global patterns in prostate cancer incidence and mortality rates[J]. Eur Urol, 2020, 77 (1): 38- 52.
doi: 10.1016/j.eururo.2019.08.005
3 Cabarrus MC , Westphalen AC . Multiparametric magnetic resonance imaging of the prostate-a basic tutorial[J]. Transl Androl Urol, 2017, 6 (3): 376- 386.
doi: 10.21037/tau.2017.01.06
4 Meng X , Rosenkrantz AB , Mendhiratta N , et al. Relationship between prebiopsy multiparametric magnetic resonance imaging (MRI), biopsy indication, and MRI-ultrasound fusion-targeted prostate biopsy outcomes[J]. Eur Urol, 2016, 69 (3): 512- 517.
doi: 10.1016/j.eururo.2015.06.005
5 Barentsz JO , Richenberg J , Clements R , et al. ESUR prostate MR guidelines 2012[J]. Eur Radiol, 2012, 22 (4): 746- 757.
doi: 10.1007/s00330-011-2377-y
6 Turkbey B , Rosenkrantz AB , Haider MA , et al. Prostate imaging reporting and data system version 2[J]. Eur Urol, 2019, 76 (3): 340- 351.
doi: 10.1016/j.eururo.2019.02.033
7 Weinreb JC , Barentsz JO , Choyke PL , et al. PI-RADS prostate imaging-reporting and data system: 2015, version 2[J]. Eur Urol, 2016, 69 (1): 16- 40.
doi: 10.1016/j.eururo.2015.08.052
8 Ahmed HU , El-Shater Bosaily A , Brown LC , et al. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate can-cer (PROMIS): A paired validating confirmatory study[J]. Lancet, 2017, 389 (10071): 815- 822.
doi: 10.1016/S0140-6736(16)32401-1
9 Epstein JI , Egevad L , Amin MB , et al. The 2014 International Society of Urological Pathology (ISUP) consensus conference on Gleason grading of prostatic carcinoma: Definition of grading patterns and proposal for a new grading system[J]. Am J Surg Pathol, 2016, 40 (2): 244- 252.
doi: 10.1097/PAS.0000000000000530
10 赫捷, 陈万青, 李霓, 等. 中国前列腺癌筛查与早诊早治指南(2022, 北京)[J]. 中华肿瘤杂志, 2022, 44 (1): 29- 53.
11 尚柳彤, 王婷婷. CT与MRI诊断前列腺癌的临床价值分析[J]. 中国CT和MRI杂志, 2016, 14 (1): 99- 101.
12 Iyama Y , Nakaura T , Kidoh M , et al. Fat suppressed contrast-enhanced T1-weighted dynamic magnetic resonance imaging at 3T: Comparison of image quality between spectrally adiabatic iversion recovery and the multiecho dixon technique in imaging of the prostate[J]. J Comput Assist Tomogr, 2017, 41 (3): 382- 387.
doi: 10.1097/RCT.0000000000000540
13 Ream JM , Doshi AM , Dunst D , et al. Dynamic contrast-enhanced MRI of the prostate: An intraindividual assessment of the effect of temporal resolution on qualitative detection and quantitative analysis of histopathologically proven prostate cancer[J]. J Magn Reson Imaging, 2017, 45 (5): 1464- 1475.
doi: 10.1002/jmri.25451
[1] Yanhua LIU, Min LU, Xuyang ZHAO, Kuan'gen ZHANG, Rui WU, Fang MEI, Zhihao DAI, Jiangfeng YOU, Fei PEI. Effect of dephosphorylation of tumor metastasis suppressor gene LASS2 on vacuolar ATPase activity and invasiveness of prostate cancer [J]. Journal of Peking University (Health Sciences), 2025, 57(6): 1113-1123.
[2] Xiaoyong YANG, Fan ZHANG, Lulin MA, Cheng LIU. Clinical characteristics and influencing factors of extraglandular invasion of prostatic ductal adenocarcinoma [J]. Journal of Peking University (Health Sciences), 2025, 57(5): 956-960.
[3] Jiaxin NING, Haoran WANG, Shuhang LUO, Jibo JING, Jianye WANG, Huimin HOU, Ming LIU. Multi-omics analysis of the relationship between oxidative stress-related gene and prostate cancer [J]. Journal of Peking University (Health Sciences), 2025, 57(4): 633-643.
[4] Zeyuan WANG, Shuanbao YU, Haoke ZHENG, Jin TAO, Yafeng FAN, Xuepei ZHANG. A preoperative prediction model for pelvic lymph node metastasis in prostate cancer: Integrating clinical characteristics and multiparametric MRI [J]. Journal of Peking University (Health Sciences), 2025, 57(4): 684-691.
[5] Yuan NING, Xiaoying ZHANG, Xue LI, Yuan LI, Jing HE, Yuebo JIN. Sjögren disease complicated by primary breast lymphoma: A case report [J]. Journal of Peking University (Health Sciences), 2025, 57(4): 808-811.
[6] Jianjun SUN, Qianquan MA, Xiaoliang YIN, Chenlong YANG, Jia ZHANG, Suhua CHEN, Chao WU, Jingcheng XIE, Yunfeng HAN, Guozhong LIN, Yu SI, Jun YANG, Haibo WU, Qiang ZHAO. Significance of precise classification of sacral meningeal cysts by multiple dimensions radiographic reconstruction MRI in guiding operative strategy and rehabilitation [J]. Journal of Peking University (Health Sciences), 2025, 57(2): 303-308.
[7] Zhicun LI, Tianyu WU, Lei LIANG, Yu FAN, Yisen MENG, Qian ZHANG. Risk factors analysis and nomogram model construction of postoperative pathological upgrade of prostate cancer patients with single core positive biopsy [J]. Journal of Peking University (Health Sciences), 2024, 56(5): 896-901.
[8] Yuxuan TIAN,Mingjian RUAN,Yi LIU,Derun LI,Jingyun WU,Qi SHEN,Yu FAN,Jie JIN. Predictive effect of the dual-parametric MRI modified maximum diameter of the lesions with PI-RADS 4 and 5 on the clinically significant prostate cancer [J]. Journal of Peking University (Health Sciences), 2024, 56(4): 567-574.
[9] Kaifeng YAO,Mingjian RUAN,Derun LI,Yuxuan TIAN,Yuke CHEN,Yu FAN,Yi LIU. Diagnostic efficacy of targeted biopsy combined with regional systematic biopsy in prostate cancer in patients with PI-RADS 4-5 [J]. Journal of Peking University (Health Sciences), 2024, 56(4): 575-581.
[10] Junyong OU,Kunming NI,Lulin MA,Guoliang WANG,Ye YAN,Bin YANG,Gengwu LI,Haodong SONG,Min LU,Jianfei YE,Shudong ZHANG. Prognostic factors of patients with muscle invasive bladder cancer with intermediate-to-high risk prostate cancer [J]. Journal of Peking University (Health Sciences), 2024, 56(4): 582-588.
[11] Yi LIU,Chang-wei YUAN,Jing-yun WU,Qi SHEN,Jiang-xi XIAO,Zheng ZHAO,Xiao-ying WANG,Xue-song LI,Zhi-song HE,Li-qun ZHOU. Diagnostic efficacy of prostate cancer using targeted biopsy with 6-core systematic biopsy for patients with PI-RADS 5 [J]. Journal of Peking University (Health Sciences), 2023, 55(5): 812-817.
[12] Ying LIU,Ran HUO,Hui-min XU,Zheng WANG,Tao WANG,Hui-shu YUAN. Correlations between plaque characteristics and cerebral blood flow in patients with moderate to severe carotid stenosis using magnetic resonance vessel wall imaging [J]. Journal of Peking University (Health Sciences), 2023, 55(4): 646-651.
[13] Qiang FU,Guan-ying GAO,Yan XU,Zhuo-hua LIN,You-jing SUN,Li-gang CUI. Comparative study of ultrasound and magnetic resonance imaging in the diagnosis of asymptomatic anterosuperior acetabular labrum tears [J]. Journal of Peking University (Health Sciences), 2023, 55(4): 665-669.
[14] Yan XIONG,Xin LI,Li LIANG,Dong LI,Li-min YAN,Xue-ying LI,Ji-ting DI,Ting LI. Evaluation of accuracy of pathological diagnosis based on thyroid core needle biopsy [J]. Journal of Peking University (Health Sciences), 2023, 55(2): 234-242.
[15] Dan-feng ZHENG,Jun-yu LI,Jia-xi LI,Ying-shuang ZHANG,Yan-feng ZHONG,Miao YU. Pathologic features of paraspinal muscle biopsies in patients with adolescent idiopathic scoliosis [J]. Journal of Peking University (Health Sciences), 2023, 55(2): 283-291.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
No Suggested Reading articles found!
Copyright © Journal of Peking University (Health Sciences), All Rights Reserved.
Powered by Beijing Magtech Co. Ltd