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Original Research

Quantitative 3-T Multiparametric MRI Parameters as Predictors of Aggressive Prostate Cancer

Published Online:Jan 3 2025https://doi.org/10.1148/rycan.240011

Abstract

Quantitative 3-T multiparametric MRI parameters correlated with and helped predict the presence of aggressive large cribriform pattern and intraductal carcinoma prostate cancer at whole-mount histopathology.

Purpose

To determine which quantitative 3-T multiparametric MRI (mpMRI) parameters correlate with and help predict the presence of aggressive large cribriform pattern (LCP) and intraductal carcinoma (IDC) prostate cancer (PCa) at whole-mount histopathology (WMHP).

Materials and Methods

This retrospective study included 130 patients (mean age ± SD, 62.6 years ± 7.2; 100% male) with 141 PCa lesions who underwent preoperative prostate 3-T mpMRI, radical prostatectomy, and WMHP between January 2019 and December 2022. Lesions at WMHP were matched to 3-T mpMRI lesions with American College of Radiology Prostate Imaging Reporting and Data System version 2.1 scores of at least 3 or higher, and the following parameters were derived: apparent diffusion coefficient (ADC), volume transfer constant, rate constant, and initial area under the curve (iAUC). Each lesion was categorized into three subcohorts with increasing aggressiveness: LCP negative and IDC negative (subcohort 1), LCP positive and IDC negative (subcohort 2), and LCP positive and IDC negative (subcohort 3). Analysis of variance was performed to assess differences, Jonckheere test was performed to establish trends, and a classification and regression tree (CART) was used to establish a prediction model.

Results

Of the 141 total lesions, there were 41 (29.1%), 49 (34.8%), and 51 (36.2%) lesions in subcohorts 1, 2, and 3, with mean ADCs of 892 × 10−6 mm2/sec ± 20, 826 × 10−6 mm2/sec ± 209, and 763 × 10−6 mm2/sec ± 163 (P = .007) and mean iAUCs of 5.4 mmol/L/sec ± 2.5, 6.7 mmol/L/sec ± 3.0, and 6.9 mmol/L/sec ± 3.5 (P = .04), respectively. ADC was negatively correlated (P = .004), and rate constant and iAUC were positively correlated (P = .048 and P = .04, respectively) with increasing histologic PCa aggressiveness. The CART model correctly allocated 39.0%, 24.5%, and 84.3% of PCa lesions to subcohorts 1, 2, and 3, respectively.

Conclusion

Quantitative 3-T mpMRI parameters significantly correlated with and helped predict aggressive LCP and IDC PCa at WMHP.

Keywords: Prostate, MRI, Pathology

© RSNA, 2025

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Article History

Received: Jan 17 2024
Revision requested: Feb 29 2024
Revision received: Oct 28 2024
Accepted: Nov 20 2024
Published online: Jan 3 2025