Quantitative contrast-enhanced perfusion kinetics in multiparametric MRI in differentiating prostate cancer from chronic prostatitis: results from a pilot study.

OBJECTIVE

The objectives of the study were to analyze the apparent diffusion coefficient (ADC), ktrans, kep metrics in dynamic contrast-enhanced multiparametric MRI (DCE-mpMRI) in biopsy proven cases of prostate cancer (PCa) and prostatitis and to establish "cut-off" values for various pharmacokinetic parameters that may distinguish PCa from chronic prostatitis.

METHODS

A retrospective review of all cases of PCa and chronic prostatitis patients, who underwent DCE-mpMRI in our institute was done from July 2017 to January 2019. Mean ADC, ktrans , kep for lesion "L" (ADCL, ktrans L , kepL) and normal prostate tissue "N" (ADCN, ktrans N , kepN ,) were calculated for each region of interest. Different ratios ADC ratio (defined as ADCL/ ADCN), ktrans ratio (ktrans L/ ktrans N), kepratio (kepL/kepN) were calculated to differentiate PCa from chronic prostatitis.

RESULTS

Total of biopsy proven 14 cases of PCa and 18 cases of chronic prostatitis were included in the study. For ktrans ratio, the optimal cut-off was at 1.49 units where sensitivity was 85.7%, specificity was 61.1 % and Youden's index was 0.468 %. Similarly, optimal cut-offs determined for kep lesion was 0.86 (sensitivity 85.7%, specificity 66.7%, J = 0.524) and for kep ratio was 1.34 units (sensitivity 78.6%, specificity 66.7%, J = 0.543).

CONCLUSION

DCE-mpMRI metrics could differentiate between PCa and chronic prostatitis with good specificity and sensitivity, while ProstateImaging Reporting and Data System v. 2 alone, did not differentiate between these patterns.

ADVANCES IN KNOWLEDGE: ktrans ratio, kep lesion and kep ratio can differentiate PCa from chronic prostatitis.