Multi-parametric magnetic resonance imaging of prostate cancer: correlation between Ktrans, Gleason score, and PI-RADS score

Abstract

Abstract Purpose To measure Ktrans and correlate it with Gleason score (GS) and PI-RADS score in patients with prostate cancer. Methods This retrospective study included patients with pathologically proven prostate cancer who had undergone clinically indicated 1.5 Tesla multi-parametric magnetic resonance imaging (MRI) examination between February and December 2020. T2-weighted (T2w) images, diffusion-weighted images (DWI), and dynamic contrast-enhanced (DCE) sequences were obtained. PI-RADS score was calculated for all tumor lesions. From DCE-MRI dataset, Ktrans was computed and compared between patients with clinically insignificant (GS ≤ 6) and clinically significant (GS ≥ 7) prostate cancer. Spearman rank-order correlation coefficient (ρ) was used to assess the correlation strength between Ktrans and GS and between Ktrans and PI-RADS score. Results Twenty-one patients (age: 67 ± 12 years; BMI: 26.63 ± 4.04 kg/m2) with a PSA of 7.91 ± 3.01 were included in the study. Seven patients (33.3%) had clinically insignificant prostate cancer, while 14 patients (66.7%) were diagnosed with clinically significant prostate cancer. Mean Ktrans value was 0.42 ± 0.20 min−1 (range: 0.15–0.75). Ktrans was significantly higher (0.50 ± 0.17 min−1) in clinically significant prostate cancer compared to clinical insignificant prostate cancer (0.23 ± 0.15 min−1; P = 0.001). Ktrans showed moderate significant correlation with GS (ρ = 0.575, P = 0.006), but showed no significant correlation with PI-RADS (ρ = 0.386, P = 0.069). Conclusion Ktrans may discriminate between clinically insignificant and significant prostate cancer and shows moderate correlation with GS. Thus, MP-MRI may serve as an imaging biomarker in prostate cancer.