A comparison of arterial spin labeling perfusion MRI and DCE-MRI in human prostate cancer.
Level 4 - case-series / case-control
Cross-sectional comparative diagnostic imaging study in a single patient cohort
PubMed 24809332 · doi:10.1002/nbm.3124
What was done
Forty-three consecutive patients with pathologically confirmed prostate cancer (aged 49–86 years, median age 74) underwent both dynamic contrast-enhanced MRI (DCE-MRI) and arterial spin labeling (ASL) perfusion MRI at 3.0 T. ASL scans were performed using four different inversion times (TI = 1000, 1200, 1400, and 1600 ms). Blood flow (BF) derived from ASL was compared between cancerous and noncancerous peripheral zone regions using independent t-tests, and Spearman correlation was used to assess associations between ASL BF and DCE-MRI pharmacokinetic parameters (Ktrans, kep, and ve).
What was found
Mean blood flow values in cancerous tissue were significantly higher than in noncancerous tissue across all inversion times (all p < 0.01): - TI = 1000 ms: 97.1 ± 30.7 vs. 35.8 ± 12.5 ml/100 g/min - TI = 1200 ms: 114.7 ± 28.7 vs. 42.2 ± 13.7 ml/100 g/min - TI = 1400 ms: 102.3 ± 22.5 vs. 53.5 ± 19.1 ml/100 g/min - TI = 1600 ms: 91.2 ± 24.2 vs. 48.5 ± 13.5 ml/100 g/min Significant positive correlations (all p < 0.01) were observed between ASL BF and DCE-MRI parameters across all TIs: - Ktrans: r = 0.671 (1000 ms), 0.713 (1200 ms), 0.604 (1400 ms), 0.605 (1600 ms) - kep: r = 0.407 (1000 ms), 0.424 (1200 ms), 0.402 (1400 ms), 0.422 (1600 ms) - ve: r = 0.666 (1000 ms), 0.698 (1200 ms), 0.595 (1400 ms), 0.548 (1600 ms)
Why it matters
Arterial spin labeling provides quantitative perfusion measurements that distinguish prostate cancer from benign tissue and correlate with contrast-derived pharmacokinetic metrics, supporting ASL as a noninvasive, contrast-agent-free alternative to DCE-MRI.
Limits
The sample size was modest (43 patients) from a single center. The study focused exclusively on peripheral zone lesions, leaving transition zone performance unaddressed, and the abstract did not report formal diagnostic accuracy metrics such as sensitivity, specificity, or ROC AUC.
Cited by
- supports The prostate receives relatively low blood flow compared to other tissues.