Blood oxygenation level-dependent MRI at 3T for differentiating prostate cancer from benign tissue: a preliminary experience

Abstract

Objective: Blood oxygenation-level dependent (BOLD) MRI may identify or quantify the regional distribution of hypoxia within a tumor. We aimed to evaluate the feasibility of BOLD MRI at 3 T in differentiating prostate cancer from benign tissue. Methods: A total of 145 patients with biopsy-proven prostate cancer underwent BOLD MRI at 3 T. BOLD MRI was performed using a multiple fast field echo sequence to acquire 12 T2*-weighted images. The R2* value (rate of relaxation, s−1) was measured in the index tumor, and benign peripheral (PZ) and transition zone (TZ), and the results were compared. The variability of R2* measurements was evaluated. Results: Tumor R2* values (25.95 s−1) were significantly different from the benign PZ (27.83 s−1) and benign TZ (21.66 s−1) (p < 0.001). For identifying the tumor, the area under the receiver operating characteristic of R2* was 0.606, with an optimal cut-off value of 22.8 s−1 resulting in 73.8% sensitivity and 52% specificity. In the Bland–Altman test, the mean differences in R2* values were 8.5% for tumors, 13.3% for benign PZ, and 6.8% for benign TZ. No associations between tumor R2* value and Gleason score, age, prostate volume, prostate-specific antigen, or tumor size. Conclusion: BOLD MRI at 3 T appears to be a feasible tool for differentiating between prostate cancer and benign tissue. However, further studies are required for a direct clinical application. Advances in knowledge: The R2* values are significantly different among prostate cancer, benign PZ, and benign TZ.