Dynamic Contrast-Enhanced MRI of the Prostate: Can Auto-Generated Wash-in Color Map Be Useful in Detecting Focal Lesion Enhancement?

Ji Min Yoon; Moon Hyung Choi; Young Joon Lee; Seung Eun Jung

doi:10.13104/imri.2019.23.3.220

Journal List > Investig Magn Reson Imaging > v.23(3) > 1135551

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Yoon, Choi, Lee, and Eun Jung: Dynamic Contrast-Enhanced MRI of the Prostate: Can Auto-Generated Wash-in Color Map Be Useful in Detecting Focal Lesion Enhancement?

Original Article

iMRI 2019;23(3):220-227.

Published online: 12 January 2019

DOI: https://doi.org/10.13104/imri.2019.23.3.220

Dynamic Contrast-Enhanced MRI of the Prostate: Can Auto-Generated Wash-in Color Map Be Useful in Detecting Focal Lesion Enhancement?

Ji Min Yoon, Moon Hyung Choi, Young Joon Lee, Seung Eun Jung

^¹Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

^²Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

^³Catholic Smart Imaging Center, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea

Correspondence to: Moon Hyung Choi, M.D. Department of Radiology, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 1021 Tongil-ro, Eunpyeong-gu, Seoul 03312, Korea. Tel. +82-2-2030-3013 Fax. +82-2-2030-3026 E-mail: cmh@catholic.ac.kr

Received 17 April 2019 Revised 19 June 2019 Accepted 29 July 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the usefulness of wash-in color map in detecting early enhancement of prostate focal lesion compared to whole dynamic contrast-enhanced MRI (DEC MRI) images.

Materials and Methods

This study engaged 50 prostate cancer patients who underwent multiparametric MRI and radical prostatectomy as subjects. An expert [R1] and a trainee [R2] independently evaluated early enhancement and recorded the time needed to review 1) a wash-in color map and 2) whole DCE MRI images.

Results

The review of whole DCE images by R1 showed fair agreement with color map by R1, whole images by R2, and color map by R2 (weighted kappa values = 0.59, 0.44, and 0.58, respectively). Both readers took a significantly shorter time to review the color maps as compared to whole images (P < 0.001).

Conclusion

A trainee could achieve better agreement with an expert when using wash-in color maps than when using whole DCE MRI images. Also, color maps took a significantly shorter evaluation time than whole images.

Keywords: Prostate cancer, Magnetic resonance imaging, Dynamic contrast-enhanced imaging

References

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Fig. 1.

A 66-year-old male patient with prostate cancer (Gleason score 8 [4+4]). Focal low signal intensity is shown at the right peripheral zone (arrows) on T2WI (a) and T1WI (b). The lesion showed diffusion restriction on DWI (c) and the ADC map (d). Early enhancement was noted on DCE whole images (e) and the color map (f).

Fig. 2.

Box-whisker plot of the time consumed by two readers for evaluating DCE whole images and color maps.

Fig. 3.

Differences in confidence scores (a) with respect to evaluation time (b) with respect to Gleason score.

Table 1.

Baseline Characteristics

Age (years), mean ± SD (range)	67.1 ± 6.6 (50–79)
PSA (ng/mL), mean ± SD (range)	12.0 ± 11.9 (3.52–62.68)
Gleason score, n (%)
≤ 6	6 (12.0)
7 (3+4)	15 (30.0)
7 (4+3)	19 (38.0)
8	8 (16.0)
9 or 10	2 (10.0)
T stage, n (%)
T2a	4 (8.0)
T2b	1 (2.0)
T2c	26 (52.0)
T3a	12 (24.0)
T3b	6 (12.0)
T4	1 (2.0)

PSA = prostate specific antigen; SD = standard deviation

Table 2.

Comparison of Confidence Grades from Two Readers between DCE Whole Images and Color Maps

		R1, DCE whole images
		1	2	3	4	5	6
R1, color map	1	0	0	0	0	0	0
	2	3	2	1	1	1	1
	3	1	1	1	0	0	1
	4	0	1	0	0	1	1
	5	1	1	1	1	3	6
	6	1	0	0	0	2	18
R2, DCE whole images	1	0	0	0	0	0	0
	2	1	4	0	0	0	1
	3	1	0	1	0	0	3
	4	2	0	1	0	0	3
	5	1	1	1	2	5	9
	6	1	0	0	0	2	11
R2, color map	1	0	0	1	0	0	0
	2	4	1	0	0	1	3
	3	1	1	0	0	1	1
	4	1	1	0	0	0	1
	5	0	2	2	2	3	8
	6	0	0	0	0	2	14

DCE = dynamic contrast enhanced

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