Differentiation of prostatic carcinoma and benign prostatic hyperplasia: Correlation between dynamic Gd-DTPA-enhanced MR imaging and histopathology

One of the major factors limiting the staging accuracy of conventional magn etic resonance imaging (MRI) for prostatic carcinoma, is the similarity in signal intensity between tumor and coexisting benign prostatic hyperplasia (BPH). As neovascularity is an independent indicator of pathological state, dynamic contrast-enhanced MRI may yield additional information, This study correlates the histopathological findings from 12 radical prostatectomy pa tients on a region-by-region basis, with pharmacokinetic modeling of dynami c contrast-enhanced (0.2 mmol dimeglumine gadopentetate/kg), fast multiplan ar spoilt gradient-recalled echo images, using a two-compartment simplex mi nimization technique. Quantitative analysis demonstrated differences in the amplitude of the initial contrast upslope and contrast exchange rate betwe en tumor and fibromuscular BPH (P < 0.03 and P < 0.03, respectively) and fo r the contrast exchange rate between tumor and fibroglandular BPH (P < 0.04 ), providing improved delineation of intraprostatic tumor extent compared w ith conventional imaging techniques. J. Magn. reson. Imaging 1999; 9:311-31 .6, (C) 1999 Wiley-Liss, Inc.