Multi-parametric (mp) MRI of prostatic ductal adenocarcinoma

  • Coffey N
  • Schieda N
  • Cron G
 et al. 
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BackgroundProstatic ductal adenocarcinoma (DCa) is an aggressive variant of conventional adenocarcinoma (CCa) with mixed DCa and CCa tumors comprising up to 5% of all prostate cancers. DCa may be underestimated on T2-weighted (T2W) MRI. This study assessed the mp-MRI appearance of DCa as compared with CCa. MethodsWith research ethics board approval, we identified 38 patients who underwent mp-MRI (T2W, DWI, and DCE) and radical prostatectomy (RP) between 2012 and 2014. Eight DCa in 8 patients and 39 CCa tumor foci in 30 consecutive patients were identified. Tumor volume, apparent diffusion coefficient (ADC;10(-3) mm(2) /s), and time-signal intensity (SI) curves were calculated. Parametric data were compared using the Kruskal-Wallis test and univariate regression. Time-SI curves were compared using the chi-square test. ResultsTumor volumes were: 1.62(1.02) for DCa, 1.03(+/- 0.54) for Gleason 9, 0.88(+/- 0.93) for Gleason 7/8, and 0.26(+/- 0.14) mL for Gleason 6. There was no difference in size between DCa and Gleason 9 (P=0.22); however, DCa were larger than Gleason 7/8 (P=0.03) and Gleason 6 (P=0.003) tumors. ADC values were: 0.789(+/- 0.22) for DCa, 1.01(+/- 0.19) for Gleason 9, 0.992(+/- 0.23) for Gleason 7/8 and 1.389(+/- 0.41) 10(-3) mm(2) /s for Gleason 6 tumors. There was no difference in ADC between DCa and Gleason 9 (P=0.14) or Gleason 7/8 (P=0.055) tumors. There was a difference in ADC for DCa and Gleason 7 CCa compared to Gleason 6 tumors, (P

Author-supplied keywords

  • Gleason score and grade
  • active surveillance
  • ductal adenocarcinoma
  • magnetic resonance imaging
  • prostate cancer

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  • Niamh Coffey

  • Nicola Schieda

  • Greg Cron

  • Previn Gulavita

  • Kien T. Mai

  • Trevor A. Flood

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