Determination of the Association Between T2-weighted MRI and Gleason Sub-pattern: A Proof of Principle Study

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• 作者：Michelle R. Downes ; MBBChBAO ; MRCSI ; MD ; FRCPC^a ; ^{michelle.downes@sunnybrook.ca" class="auth_mail" title="E-mail the corresponding author} ; Eli Gibson ; PhD^b ; ^c ; Jenna Sykes ; MMath^d ; ^e ; Masoom Haider ; MD ; FRCPC^f ; Theo H. van der Kwast ; MD ; PhD^g ; Aaron Ward ; PhD^h
• 关键词：Prostate ; sub-pattern ; T2W
• 刊名：Academic Radiology
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：23
• 期：11
• 页码：1412-1421
• 全文大小：1636 K

文摘

The study aimed to determine the relationship between T2-weighted magnetic resonance imaging (MRI) signal and histologic sub-patterns in prostate cancer areas with different Gleason grades.

Materials and Methods

MR images of prostates (n = 25) were obtained prior to radical prostatectomy. These were processed as whole-mount specimens with tumors and the peripheral zone was annotated digitally by two pathologists. Gleason grade 3 was the most prevalent grade and was subdivided into packed, intermediate, and sparse based on gland-to-stroma ratio. Large cribriform, intraductal carcinoma, and small cribriform glands (grade 4 group) were separately annotated but grouped together for statistical analysis. The log MRI signal intensity for each contoured region (n = 809) was measured, and pairwise comparisons were performed using the open-source software R version 3.0.1.

Results

Packed grade 3 sub-pattern has a significantly lower MRI intensity than the grade 4 group (P < 0.00001). Sparse grade 3 has a significantly higher MRI intensity than the packed grade 3 sub-pattern (P < 0.0001). No significant difference in MRI intensity was observed between the Gleason grade 4 group and the sparse sub-pattern grade 3 group (P = 0.54). In multivariable analysis adjusting for peripheral zone, the P values maintained significance (packed grade 3 group vs grade 4 group, P < 0.001; and sparse grade 3 sub-pattern vs packed grade 3 sub-pattern, P < 0.001).

Conclusions

This study demonstrated that T2-weighted MRI signal is dependent on histologic sub-patterns within Gleason grades 3 and 4 cancers, which may have implications for directed biopsy sampling and patient management.