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Radiology. 2017 Oct;285(1):147-156. doi: 10.1148/radiol.2017160906. Epub 2017 Jun 5.

Prostate Cancer: A Correlative Study of Multiparametric MR Imaging and Digital Histopathology.

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From the Department of Computer Science and Engineering, Sejong University, Seoul, Korea (J.T.K.); Molecular Imaging Program, National Cancer Institute (S.S., B.T., P.L.C.), Center for Interventional Oncology (S.X., B.J.W.), Urologic Oncology Branch, National Cancer Institute (P.A.P.), and Laboratory of Pathology, National Cancer Institute (V.M., M.M.), National Institutes of Health, 10 Center Dr, Room 1C341, Bethesda, MD 20892.


Purpose To correlate multiparametric magnetic resonance (MR) imaging and quantitative digital histopathologic analysis (DHA) of the prostate. Materials and Methods This retrospective study was approved by the local institutional review board and was HIPAA compliant. Forty patients (median age, 60 years; age range, 44-71 years) who underwent prostate MR imaging consisting of T2-weighted and diffusion-weighted (DW) MR imaging along with subsequent robot-assisted radical prostatectomy gave informed consent to be included. Whole-mount tissue specimens were obtained with a patient-specific mold, and DHA was performed to assess the lumen, epithelium, stroma, and epithelial nucleus. These DHA images were registered with MR images and were correlated on a per-voxel basis. The relationship between MR imaging and DHA was assessed by using a linear mixed-effects model and the Pearson correlation coefficient. Results T2-weighted MR imaging, apparent diffusion coefficient (ADC) of DW imaging, and high-b-value DW imaging were significantly related to specific DHA parameters (P < .01). For instance, lumen density (ie, the percentage area of tissue components) was associated with T2-weighted MR imaging (slope = 0.36 ± 0.05 [standard error], γ = 0.35), ADC (slope = 0.47 ± 0.05, γ = 0.50), and high-b-value DW imaging (slope = -0.44 ± 0.05, γ = -0.44). Differences between regions harboring benign tissue and those harboring malignant tissue were observed at MR imaging and DHA (P < .01). Gleason score was significantly associated with MR imaging and DHA parameters (P < .05). For example, it was positively related to high-b-value DW imaging (slope = 0.21 ± 0.16, γ = 0.18) and negatively related to lumen density (slope = -0.19 ± 0.18, γ = -0.35). Conclusion Overall, significant associations were observed between MR imaging and DHA, regardless of prostate anatomy. © RSNA, 2017 Online supplemental material is available for this article.

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