Multi-parametric (mp) MRI of prostatic ductal adenocarcinoma

• Published in: Journal of magnetic resonance imaging 2015-06, Vol.41 (6), p.1639-1645
• Main Authors: Coffey, Niamh, Schieda, Nicola, Cron, Greg, Gulavita, Previn, Mai, Kien T, Flood, Trevor A.
• Format: Article
• Language: English
• Subjects: active surveillance; Adenocarcinoma - pathology; Adenocarcinoma - surgery; Aged; Clinical outcomes; Contrast Media; ductal adenocarcinoma; Gleason score and grade; Humans; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Middle Aged; prostate cancer; Prostatectomy; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Retrospective Studies; Tumors
• ISSN: 1053-1807; 1522-2586
• DOI: 10.1002/jmri.24694

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