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Simplified Luminal Water Imaging for the Detection of Prostate Cancer From Multiecho T2 MR Images

Devine, W; Giganti, F; Johnston, EW; Sidhu, HS; Panagiotaki, E; Punwani, S; Alexander, DC; (2018) Simplified Luminal Water Imaging for the Detection of Prostate Cancer From Multiecho T2 MR Images. Journal of Magnetic Resonance Imaging 10.1002/jmri.26608. (In press). Green open access

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Abstract

BACKGROUND: Luminal water imaging (LWI) suffers less from imaging artifacts than the diffusion-weighted imaging used in multiparametric MRI of the prostate. LWI obtains multicompartment tissue information from a multiecho T2 dataset. PURPOSE: To compare a simplified LWI technique with apparent diffusion coefficient (ADC) in classifying lesions based on groupings of PI-RADS v2 scores. Secondary aims were to investigate whether LWI differentiates between histologically confirmed tumor and normal tissue as effectively as ADC, and whether LWI is correlated with the multicompartment parameters of the vascular, extracellular, and restricted diffusion for cytometry in tumors (VERDICT) diffusion model. STUDY TYPE: A subset of a larger prospective study. POPULATION: In all, 65 male patients aged 49-79 were scanned. FIELD STRENGTH/SEQUENCE: A 32-echo T2 and a six b-value diffusion sequence (0, 90, 500, 1500, 2000, 3000 s/mm2 ) at 3T. ASSESSMENT: Regions of interest were placed by a board-certified radiologist in areas of lesion and benign tissue and given PI-RADS v2 scores. STATISTICAL TESTS: Receiver operating characteristic and logistic regression analyses were performed. RESULTS: LWI classifies tissue as PI-RADS 1,2 or PI-RADS 3,4,5 with an area under curve (AUC) value of 0.779, compared with 0.764 for ADC. LWI differentiated histologically confirmed malignant from nonmalignant tissue with AUC, sensitivity, and specificity values of 0.81, 75%, and 87%, compared with 0.75, 83%, and 67% for ADC. The microstructural basis of the LWI technique is further suggested by the correspondence with the VERDICT diffusion-based microstructural imaging technique, with α, A1 , A2 , and LWF showing significant correlations. DATA CONCLUSION: LWI alone can predict PI-RADS v2 score groupings and detect histologically confirmed tumors with an ability similar to ADC alone without the limitations of diffusion-weighted MRI. This is important, given that ADC has an advantage in these tests as it already informs PI-RADS v2 scoring. LWI also provides multicompartment information that has an explicit biophysical interpretation, unlike ADC. LEVEL OF EVIDENCE: 3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.

Type: Article
Title: Simplified Luminal Water Imaging for the Detection of Prostate Cancer From Multiecho T2 MR Images
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1002/jmri.26608
Publisher version: http://doi.org/10.1002/jmri.26608
Language: English
Additional information: Copyright © 2018 The Authors. Journal of Magnetic Resonance Imaging published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine.
Keywords: cancer, microstructure, modeling, multiecho T2, prostate
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Department of Imaging
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Computer Science
URI: https://discovery.ucl.ac.uk/id/eprint/10065048
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