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- Title
Multi-parametric (mp) MRI of prostatic ductal adenocarcinoma.
- Authors
Coffey, Niamh; Schieda, Nicola; Cron, Greg; Gulavita, Previn; Mai, Kien T; Flood, Trevor A.
- Abstract
Background Prostatic ductal adenocarcinoma (DCa) is an aggressive variant of conventional adenocarcinoma (CCa) with mixed DCa and CCa tumors comprising up to 5% of all prostate cancers. DCa may be underestimated on T2-weighted (T2W) MRI. This study assessed the mp-MRI appearance of DCa as compared with CCa. Methods With research ethics board approval, we identified 38 patients who underwent mp-MRI (T2W, DWI, and DCE) and radical prostatectomy (RP) between 2012 and 2014. Eight DCa in 8 patients and 39 CCa tumor foci in 30 consecutive patients were identified. Tumor volume, apparent diffusion coefficient (ADC;10−3 mm2 /s), and time-signal intensity (SI) curves were calculated. Parametric data were compared using the Kruskal-Wallis test and univariate regression. Time-SI curves were compared using the chi-square test. Results Tumor volumes were: 1.62(±1.02) for DCa, 1.03(±0.54) for Gleason 9, 0.88(±0.93) for Gleason 7/8, and 0.26(±0.14) mL for Gleason 6. There was no difference in size between DCa and Gleason 9 ( P = 0.22); however, DCa were larger than Gleason 7/8 ( P = 0.03) and Gleason 6 ( P = 0.003) tumors. ADC values were: 0.789(±0.22) for DCa, 1.01(±0.19) for Gleason 9, 0.992(±0.23) for Gleason 7/8 and 1.389(±0.41) 10−3 mm2 /s for Gleason 6 tumors. There was no difference in ADC between DCa and Gleason 9 ( P = 0.14) or Gleason 7/8 ( P = 0.055) tumors. There was a difference in ADC for DCa and Gleason ≥7 CCa compared to Gleason 6 tumors, ( P < 0.001 and P = 0.012). All DCa demonstrated type III time-SI curves. Gleason ≥ 7 tumors demonstrated type II/III curves. Gleason 6 tumors demonstrated Type I/II time-SI curves. There was no difference in curve type between groups, ( P = 0.18). Conclusion Although DCa mimics Gleason score 3 + 3 = 6 tumor at T2W MRI; DCa resembles Gleason ≥7 CCa on mp-MRI. J. Magn. Reson. Imaging 2015;41:1639-1645. © 2014 Wiley Periodicals, Inc.
- Publication
Journal of Magnetic Resonance Imaging, 2015, Vol 41, Issue 6, p1639
- ISSN
1053-1807
- Publication type
Article
- DOI
10.1002/jmri.24694