Diagnostic and Interventional Radiology
Abdominal Imaging - Original Article

Role of arterial input function (AIF) for quantitative dynamic contrast-enhanced MRI (DCE) to diagnose prostate cancer

1.

Department of Diagnostic and Interventional Radiology, University Dusseldorf, Faculty of Medicine, Dusseldorf, Germany

2.

Department of Urology, University Dusseldorf, Faculty of Medicine, Dusseldorf, Germany

Diagn Interv Radiol 2020; 1: -
Read: 121 Published: 04 January 2021

PURPOSE: This study aims to analyze the ability of quantitative DCE to distinguish between prostate cancer (PCa) and benign lesions in transition zone (TZ) and peripheral zone (PZ) using different methods for AIF determination. Study endpoints are identification of a standard AIF method and optimal quantitative perfusion parameters for PCA detection.

METHODS: DCE image data of fifty consecutive patients with PCa with multiparametric MRI were analyzed retrospectively with three different methods of AIF acquisition. Firstly, a region of interest was defined in an artery (AIFm), secondly an automated algorithm was used (AIFa), thirdly a populated AIFp was applied. Values of quantitative parameters after Tofts (Ktrans, ve, kep) in PCa, PZ, and TZ in the three different AIFs were analyzed.

RESULTS: Ktrans and kep were significantly higher in PCa than in benign tissue independent from the AIF method. Whereas in PZ Ktrans and kep could differentiate PCa (p < 0.001), in TZ only kep using AIFp demonstrated a significant difference (p = 0.039). The correlations of the perfusion parameters that resulted from AIFm and AIFa were higher than those that resulted from AIFp and the absolute values of Ktrans, kep, and ve were significantly lower when using AIFp. The values of quantitative perfusion parameters for PCa were similar regardless whether PCa was located in PZ or TZ.  

CONCLUSION: Ktrans and kep were able to differentiate PCa from benign PZ independent of the AIF method. AIFa seems to be the most feasible method of AIF determination in clinical routine. For TZ, none of the quantitative perfusion parameters provided satisfying results.

EISSN 1305-3612