Is There an Added Value of Quantitative DCE-MRI by Magnetic Resonance Dispersion Imaging for Prostate Cancer Diagnosis?

Simple Summary This multicenter, retrospective study assessed the added value of magnetic resonance dispersion imaging (MRDI), a quantitative analysis of dynamic contrast-enhanced MRI (DCE-MRI), alongside standard multiparametric MRI (mpMRI) for detecting clinically significant prostate cancer (csPCa). Seventy-six patients, including fifty-one with csPCa, who underwent mpMRI and radical prostatectomy, were included. Two radiologists evaluated mpMRI, MRDI and a combination of both, with histopathology serving as the reference standard. The study found that MRDI improved inter-observer agreement and enhanced csPCa detection when combined with mpMRI. MRDI enabled the detection of up to 20% more cases compared to mpMRI alone. With the role of DCE-MRI in the context of mpMRI being debated, this study suggests that quantitative analysis of DCE-MRI by MRDI could enhance csPCa detection and reduce variability between observers.Abstract In this multicenter, retrospective study, we evaluated the added value of magnetic resonance dispersion imaging (MRDI) to standard multiparametric MRI (mpMRI) for PCa detection. The study included 76 patients, including 51 with clinically significant prostate cancer (csPCa), who underwent radical prostatectomy and had an mpMRI including dynamic contrast-enhanced MRI. Two radiologists performed three separate randomized scorings based on mpMRI, MRDI and mpMRI+MRDI. Radical prostatectomy histopathology was used as the reference standard. Imaging and histopathology were both scored according to the Prostate Imaging-Reporting and Data System V2.0 sector map. Sensitivity and specificity for PCa detection were evaluated for mpMRI, MRDI and mpMRI+MRDI. Inter- and intra-observer variability for both radiologists was evaluated using Cohen's Kappa. On a per-patient level, sensitivity for csPCa for radiologist 1 (R1) for mpMRI, MRDI and mpMRI+MRDI was 0.94, 0.82 and 0.94, respectively. For the second radiologist (R2), these were 0.78, 0.94 and 0.96. R1 detected 4% additional csPCa cases using MRDI compared to mpMRI, and R2 detected 20% extra csPCa cases using MRDI. Inter-observer agreement was significant only for MRDI (Cohen's Kappa = 0.4250, p = 0.004). The results of this study show the potential of MRDI to improve inter-observer variability and the detection of csPCa.