European radiology experimental · 2026
Validating the biological origin of in vivo fractional intracellular volume from VERDICT-MRI in the prostate.
СтатьяНаблюдательное исследованиеВалидационное исследованиеНазвание и аннотация: Перевод в очереди
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Masramon Marta, Mathew Manju, Singh Saurabh, Mertzanidou Thomy, Clemente Joey, Retter Adam, Thorley Natasha, Phipps Adam, Parry Thomas, Papoutsaki Marianti-Vasiliki, Smith Lorna, Grussu Francesco, Kasivisvanathan Veeru, Grey Alistair, Dinneen Eoin, Shaw Greg, Patel Dominic, Caselton Lucy, Moore Caroline M, Atkinson David, Haider Aiman, Freeman Alex, Alexander Daniel C, Punwani Shonit, Panagiotaki Eleftheria
Аннотация
OBJECTIVE: Noninvasive microstructure estimates using magnetic resonance imaging (MRI) show potential in improving prostate cancer (PCa) diagnosis; however, histological validation is necessary.
MATERIALS AND METHODS: We used data from the Histo-MRI trial (NCT04792138). Participants with biopsy-confirmed PCa underwent multiparametric (mp) MRI and "vascular, extracellular, and restricted diffusion for cytometry in tumors" (VERDICT)-MRI before radical prostatectomy. Personalized molds enabled matching prostatectomy histology with corresponding VERDICT-MRI images. Comparisons between histological epithelial cell density measures and MRI were made on a region-of-interest (ROI) basis using Pearson correlation coefficient (r) with 95% confidence interval (CI). Differences between benign tissue and clinically significant PCa were analyzed using the area under the receiver operating characteristic curve (AUC).
RESULTS: Fifty-two participants, aged 65 ± 6 years (mean ± standard deviation), with Gleason grade ≥ 3 + 4, were included. ROI analysis showed stronger correlations of VERDICT fractional intracellular volume (fIC) with epithelial fraction, epithelial cell density, and cell density (r = 0.784 [0.70, 0.84], 0.747 [0.66, 0.81], 0.711 [0.60, 0.79] than VERDICT ADC (r = -0.639 [-0.54, -0.71], -0.609 [-0.51, -0.69], -0.587 [-0.45, -0.69]), or mpMRI ADC (r = -0.357 [-0.18, -0.51], -0.315 [-0.15, -0.46], -0.266 [-0.08, -0.43]), respectively (p < 0.001). VERDICT fIC showed similar differences between benign and clinically significant PCa (0.16 ± 0.10 to 0.51 ± 0.13, AUC = 0.99, p < 0.001) to epithelial fraction (0.21 ± 0.08 to 0.43 ± 0.12, AUC = 0.94, p < 0.001).
CONCLUSION: VERDICT fIC showed clinical potential as a biomarker of epithelial cell density.
KEY POINTS: Question Can VERDICT-MRI fIC provide a biologically interpretable, noninvasive imaging biomarker of epithelial cell density in the prostate? Findings VERDICT fIC showed stronger correlations with histological epithelial fraction, cell density, and epithelial density than both VERDICT-derived ADC and mpMRI ADC. Relevance statement These findings support in vivo VERDICT fIC as a noninvasive biomarker of prostate epithelial microstructure and show promise for wider clinical use, improving the detection rate of clinically significant PCa, reducing unnecessary biopsies, and allowing better risk stratification.
MATERIALS AND METHODS: We used data from the Histo-MRI trial (NCT04792138). Participants with biopsy-confirmed PCa underwent multiparametric (mp) MRI and "vascular, extracellular, and restricted diffusion for cytometry in tumors" (VERDICT)-MRI before radical prostatectomy. Personalized molds enabled matching prostatectomy histology with corresponding VERDICT-MRI images. Comparisons between histological epithelial cell density measures and MRI were made on a region-of-interest (ROI) basis using Pearson correlation coefficient (r) with 95% confidence interval (CI). Differences between benign tissue and clinically significant PCa were analyzed using the area under the receiver operating characteristic curve (AUC).
RESULTS: Fifty-two participants, aged 65 ± 6 years (mean ± standard deviation), with Gleason grade ≥ 3 + 4, were included. ROI analysis showed stronger correlations of VERDICT fractional intracellular volume (fIC) with epithelial fraction, epithelial cell density, and cell density (r = 0.784 [0.70, 0.84], 0.747 [0.66, 0.81], 0.711 [0.60, 0.79] than VERDICT ADC (r = -0.639 [-0.54, -0.71], -0.609 [-0.51, -0.69], -0.587 [-0.45, -0.69]), or mpMRI ADC (r = -0.357 [-0.18, -0.51], -0.315 [-0.15, -0.46], -0.266 [-0.08, -0.43]), respectively (p < 0.001). VERDICT fIC showed similar differences between benign and clinically significant PCa (0.16 ± 0.10 to 0.51 ± 0.13, AUC = 0.99, p < 0.001) to epithelial fraction (0.21 ± 0.08 to 0.43 ± 0.12, AUC = 0.94, p < 0.001).
CONCLUSION: VERDICT fIC showed clinical potential as a biomarker of epithelial cell density.
KEY POINTS: Question Can VERDICT-MRI fIC provide a biologically interpretable, noninvasive imaging biomarker of epithelial cell density in the prostate? Findings VERDICT fIC showed stronger correlations with histological epithelial fraction, cell density, and epithelial density than both VERDICT-derived ADC and mpMRI ADC. Relevance statement These findings support in vivo VERDICT fIC as a noninvasive biomarker of prostate epithelial microstructure and show promise for wider clinical use, improving the detection rate of clinically significant PCa, reducing unnecessary biopsies, and allowing better risk stratification.