Radiology: Prostate MRI Fractal Analysis and PI-RADS in Prostate Cancer Grading

It is well known that the grading of prostate cancer (PCa) is very important for its clinical management and patient prognosis .
Clinically , the standard diagnostic approach for PCa remains digital rectal examination and assessment of prostate-specific antigen (PSA) levels .
If results were suspicious, further biopsy was performed and histologically graded according to the Gleason grading system and the five grade groups introduced by the International Society of Urological Pathology (ISUP) and WHO by the ISUP .
Among them , for patients with ISUP grade 1 lesions or a low proportion (<10%) of 2 groups of lesions with a Gleason score of 4, re-examination rather than surgical treatment can be considered , so accurate non-invasive staging is of significance for the formulation of patient treatment plans.
significant .

It is well known that the grading of prostate cancer (PCa) is very important for its clinical management and management of patient prognosis .

Clinically , the standard diagnostic pathway for PCa remains the diagnosis of digital rectal examination and assessment of prostate-specific antigen (PSA) levels .
If results were suspicious, further biopsy was performed and histologically graded according to the Gleason grading system and the five grade groups introduced by the International Society of Urological Pathology (ISUP) and WHO by the ISUP .
Among them , for patients with ISUP grade 1 lesions or a low proportion (<10%) of 2 groups of lesions with a Gleason score of 4, re-examination rather than surgical treatment can be considered , so accurate non-invasive staging is of significance for the formulation of patient treatment plans.
significant .

PCa can be divided into tumor core area and tumor marginal area
.

Angiogenesis of PCa occurred mainly at the margins, and the newly formed vessels showed a more promiscuous histological appearance compared to the more stable vessels in the tumor core

PCa can be divided into tumor core area and tumor marginal area

Recently, a study published in the journal Radiology evaluated the value of fractal analysis as a separate criterion in the assessment of PI-RADS , and explored its additional value in an integrated imaging effort for PCa detection and characterization, and compared its performance.
Compared with the ADC measurement of PCa in peripheral and transitional areas , it provides technical support for the preoperative evaluation of PCa and the formulation of treatment plan .

This study analyzed routine clinical MR imaging data of 72 prostate cancer lesions in 64 patients, all acquired under 3T MR conditions, including dynamic contrast-enhanced sequences

Fractal analysis could predict ISUP grades 1 to 4, but not grade 5, with high agreement with the reference standard (κFD = 0.
88 [CI: 0.
79-0.
98])

An example of graph fractal analysis .

Multiparametric sequences (T2-weighted, T2w; dynamic contrast enhancement, DCE; apparent diffusion coefficient, ADC) versus the fractal dimension (FD) map of the tumor .
Quantitative values ​​for ADC ₂₅ (25th percentile) or FD are given under the corresponding row .
DCE subtraction depicts a phase during the early first channel and is normalized to baseline signal strength .
 

An example of graph fractal analysis .
Multiparametric sequences (T2-weighted, T2w; dynamic contrast enhancement, DCE; apparent diffusion coefficient, ADC) versus the fractal dimension (FD) map of the tumor .
Quantitative values ​​for ADC ₂₅ (25th percentile) or FD are given under the corresponding row .
DCE subtraction depicts a phase during the early first channel and is normalized to baseline signal strength .
An example of graph fractal analysis .
Multiparametric sequences (T2-weighted, T2w; dynamic contrast enhancement, DCE; apparent diffusion coefficient, ADC) versus the fractal dimension (FD) map of the tumor .
Quantitative values ​​for ADC ₂₅ 25 (25th percentile) or FD are given under the corresponding row .
DCE subtraction depicts a phase during the early first channel and is normalized to baseline signal strength .
 

In conclusion, fractal analysis of prostate perfusion improves the diagnostic accuracy of mpMRI for detection of clinically significant cancers, further complements PI-RADS assessment, and enables a " one-stop " imaging effort for PCa detection and characterization .

At the same time , FD facilitates the concept of quantitative imaging based on valid pathophysiological models .

In conclusion, fractal analysis of prostate perfusion improves the diagnostic accuracy of mpMRI for detection of clinically significant cancers, further complements PI-RADS assessment, and enables a " one-stop " imaging effort for PCa detection and characterization .
At the same time , FD facilitates the concept of quantitative imaging based on valid pathophysiological models .

Original source :

Original source :

Florian Michallek , Henkjan Huisman , Bernd Hamm , et al .

Accuracy of fractal analysis and PI-RADS assessment of prostate magnetic resonance imaging for prediction of cancer grade groups: a clinical validation study .
DOI: 10.
1007/s00330-021-08358-y

Florian Michallek Henkjan Huisman Bernd Hamm , et al Accuracy of fractal analysis and PI-RADS assessment of prostate magnetic resonance imaging for prediction of cancer grade groups: a clinical validation study 10.
1007/s00330-021-08358-y 10.
1007/s00330-021-08358 -y leave a message here