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The Role of Pathology Correlation Approach in Prostate Cancer Index Lesion Detection and Quantitative Analysis with Multiparametric MRI

1Department of Radiology, Brigham and Women's Hospital, Boston, MA, USA.
2Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA.
3Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA.
4Department of Radiology, Children's Hospital Boston, Boston, MA, USA.
Elsevier Science
Publication Date:
Academic Radiology
Volume Number:
Issue Number:
Acad Radiol. 2015 May;22(5):548-55.
PubMed ID:
prostate cancer, quantitative imagingce imaging, Diffusion magnetic resonance imaging, pathology correlation, quantitative imaging
Appears in Collections:
Prostate Group, NCIGT, SLICER, SPL
U01 CA151261/CA/NCI NIH HHS/United States
P41 EB015898/EB/NIBIB NIH HHS/United States
R01 CA111288/CA/NCI NIH HHS/United States
T.P. received a grant from RWTH Aachen University Hospital.
Generated Citation:
Fedorov A., Penzkofer T., Hirsch M.S., Flood T.A., Vangel M.G., Masry P., Tempany C.M., Mulkern R.V., Fennessy F.M. The Role of Pathology Correlation Approach in Prostate Cancer Index Lesion Detection and Quantitative Analysis with Multiparametric MRI. Acad Radiol. 2015 May;22(5):548-55. PMID: 25683501. PMCID: PMC4429788.
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Rationale and Objectives Development of imaging biomarkers often relies on their correlation with histopathology. Our aim was to compare two approaches for correlating pathology to multiparametric magnetic resonance (MR) imaging (mpMRI) for localization and quantitative assessment of prostate cancer (PCa) index tumor using whole mount (WM) pathology (WMP) as the reference. Materials and Methods Patients (N = 30) underwent mpMRI that included diffusion-weighted imaging and dynamic contrast-enhanced (DCE) MRI at 3 T before radical prostatectomy (RP). RP specimens were processed using WM technique (WMP) and findings summarized in a standard surgical pathology report (SPR). Histology index tumor volumes (HTVs) were compared to MR tumor volumes (MRTVs) using two approaches for index lesion identification on mpMRI using annotated WMP slides as the reference (WMP) and using routine SPR as the reference. Consistency of index tumor localization, tumor volume, and mean values of the derived quantitative parameters (mean apparent diffusion coefficient [ADC], Ktrans, and ve) were compared. Results Index lesions from 16 of 30 patients met the selection criteria. There was WMP/SRP agreement in index tumor in 13 of 16 patients. ADC-based MRTVs were larger (P < .05) than DCE-based MRTVs. ADC MRTVs were smaller than HTV (P < .005). There was a strong correlation between HTV and MRTV (Pearson ρ > 0.8; P < .05). No significant differences were observed in the mean values of Ktrans and ADC between the WMP and SPR. Conclusions WMP correlation is superior to SPR for accurate localization of all index lesions. The use of WMP is however not required to distinguish significant differences of mean values of quantitative MRI parameters within tumor volume.

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