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Diagnostics 2017, 7(3), 48; doi:10.3390/diagnostics7030048

Incorporating Oxygen-Enhanced MRI into Multi-Parametric Assessment of Human Prostate Cancer

Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Analytical Imaging and Modeling Center, Children’s Medical Center, Dallas, TX 75235, USA
Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA (Present address)
Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
Author to whom correspondence should be addressed.
Received: 5 July 2017 / Revised: 13 August 2017 / Accepted: 21 August 2017 / Published: 24 August 2017
(This article belongs to the Special Issue Functional and Molecular Imaging of Kidney and Urogenital Disease)
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Hypoxia is associated with prostate tumor aggressiveness, local recurrence, and biochemical failure. Magnetic resonance imaging (MRI) offers insight into tumor pathophysiology and recent reports have related transverse relaxation rate (R2*) and longitudinal relaxation rate (R1) measurements to tumor hypoxia. We have investigated the inclusion of oxygen-enhanced MRI for multi-parametric evaluation of tumor malignancy. Multi-parametric MRI sequences at 3 Tesla were evaluated in 10 patients to investigate hypoxia in prostate cancer prior to radical prostatectomy. Blood oxygen level dependent (BOLD), tissue oxygen level dependent (TOLD), dynamic contrast enhanced (DCE), and diffusion weighted imaging MRI were intercorrelated and compared with the Gleason score. The apparent diffusion coefficient (ADC) was significantly lower in tumor than normal prostate. Baseline R2* (BOLD-contrast) was significantly higher in tumor than normal prostate. Upon the oxygen breathing challenge, R2* decreased significantly in the tumor tissue, suggesting improved vascular oxygenation, however changes in R1 were minimal. R2* of contralateral normal prostate decreased in most cases upon oxygen challenge, although the differences were not significant. Moderate correlation was found between ADC and Gleason score. ADC and R2* were correlated and trends were found between Gleason score and R2*, as well as maximum-intensity-projection and area-under-the-curve calculated from DCE. Tumor ADC and R2* have been associated with tumor hypoxia, and thus the correlations are of particular interest. A multi-parametric approach including oxygen-enhanced MRI is feasible and promises further insights into the pathophysiological information of tumor microenvironment. View Full-Text
Keywords: prostate cancer; multi-parametric MRI; Gleason score; oxygen prostate cancer; multi-parametric MRI; Gleason score; oxygen

This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Zhou, H.; Hallac, R.R.; Yuan, Q.; Ding, Y.; Zhang, Z.; Xie, X.-J.; Francis, F.; Roehrborn, C.G.; Sims, R.D.; Costa, D.N.; Raj, G.V.; Mason, R.P. Incorporating Oxygen-Enhanced MRI into Multi-Parametric Assessment of Human Prostate Cancer. Diagnostics 2017, 7, 48.

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