Journal
MAGNETIC RESONANCE IMAGING
Volume 80, Issue -, Pages 33-38Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.mri.2021.04.010
Keywords
Prostate MRI; Prostate cancer; Cancer detection; ASL; DCE
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The study aimed to evaluate the performance of Gadolinium-free arterial spin labelling (ASL) sequences as a non-invasive imaging method for prostate cancer and compare it to conventional DCE MRI. Results showed that ASL had significantly higher contrast ratios in differentiating prostate cancer from benign tissue, and was relatively accurate in detecting prostate cancer.
Purpose: To determine the capability of Gadolinium-free arterial spin labelling (ASL) sequences as novel, contrast-free, non-invasive alternative perfusion imaging method to differentiate prostate cancer (PCA) from benign prostate tissue compared to conventional DCE MRI. Methods: Thirty men with histologically confirmed PCA were included in this prospectively enrolled single center cohort study. All patients received multiparametric MRI (T2, DWI, DCE) at 3 T with additional ASL of the PCA lesion. Primary endpoint was differentiability of PCA versus benign prostate tissue by signal intensities (SI) and contrast ratios (CR) in ASL in comparison to DCE. For DCE also Signal-Enhancement-Ratio (SER) of native and early contrast enhancement SI was assessed. Secondary objectives were differences regarding PCA localisation in peripheral (PZ) or transition zone (TZ) and PCA detection. Results: In both, ASL and DCE, average SI of PCA differed significantly from SI in benign tissue in the TZ and PZ (p < 0,01, respectively). ASL had significantly higher CR discerning PCA and benign tissue in PZ and TZ (PZ = 5.19; TZ = 6.45) compared to DCE SI (PZ = 1.61; TZ = 1.43) and DCE SER (PZ = 1.59; TZ = 1.43) (p < 0.01, respectively). In subjective evaluation, PCA could be detected in ASL in 28 patients, compared to 29 in DCE. Conclusion: ASL had significantly higher CR differentiating PCA from benign tissue in PZ and TZ compared to DCE. Visual detection of PCA does not differ significantly between the two sequences. As perfusion gadoliniumbased contrast media is seen more critical in the last few years, ASL seems to be a promising alternative to DCE in PCA detection.
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