Pharmacokinetic analysis of prostate malignant lesions on multiparametric magnetic resonance imaging and correlation with gleason score

Objective: Our study aims to measure the pharmacokinetic values in differentiating malignant lesions of the prostate gland and to examine the relationship between the results and Gleason score. Materials and Methods: Between May 2021 and April 2024, 813 patients who underwent multiparametric MRI (mpMRI) due to elevated PSA values and/or suspicious DRE findings at the Department of Radiology, Yüzüncü Yıl University Faculty of Medicine Hospital were retrospectively reviewed. The images were evaluated together before biopsy in accordance with PI-RADS v2.1 guidelines, knowing the age and PSA (ng/ml) values of the patients. 51 patients who underwent biopsy and/or radical prostatectomy and had a Gleason score of 6 or higher were listed. 43 patients, aged between 47-85 years, who met the eligibility criteria were included in the study. PI-RADS score, age, PSA, prostate volume, PSA density and lesion length were recorded. Images were transferred to the workstation and lesion volume and prostate volume were measured automatically. In addition, pharmacokinetic analysis was performed by drawing ROI on the lesion and intact tissue in the same section. All data obtained were statistically analyzed. Results: PSA, PSA-D and lesion length were significantly higher in patients with GS≥8 than in patients with GS<8 (p<0.05). Pharmacokinetic parameters measured in the lesion (Ktrans, Kep, iAUC, Ve, chi2) were significantly higher than those measured in the intact tissue outside the lesion (p<0.05). Conclusion: The results presented in this study contribute to the standardization of values in tumor and normal prostate tissue for quantitative and semiquantitative parameters obtained from prostate DCI. To contribute to future studies, comparison of these parameters in larger patient groups, between different devices and imaging centers, and investigation of their reproducibility may be useful in facilitating the diagnosis of prostate cancer.