Dynamic contrast-enhanced magnetic resonance imaging of prostate cancer: A review of current methods and applications

Abstract

In many areas of oncology, dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) has proven to be a clinically useful, non-invasive functional imaging technique to quantify tumor vasculature and tumor perfusion characteristics. Tumor angiogenesis is an essential process for tumor growth, proliferation, and metastasis. Malignant lesions demonstrate rapid extravasation of contrast from the intravascular space to the capillary bed due to leaky capillaries associated with tumor neovascularity. DCE-MRI has the potential to provide information regarding blood flow, areas of hypoperfusion, and variations in endothelial permeability and microvessel density to aid treatment selection, enable frequent monitoring during treatment and assess response to targeted therapy following treatment. This review will discuss the current status of DCE-MRI in cancer imaging, with a focus on its use in imaging prostate malignancies as well as weaknesses that limit its widespread clinical use. The latest techniques for quantification of DCE-MRI parameters will be reviewed and compared.

Keywords: Prostate cancer; Prostate magnetic resonance imaging; Tumor angiogenesis; Dynamic contrast-enhanced magnetic resonance imaging; K_ep = rate constant between extracellular extravascular space and plasma space; K^trans = volume transfer constant

Core tip: Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) of prostate cancer can characterize tissue vascularity with important clinical application including aid in the detection, localization and staging, assessment of tumor aggressiveness, and assessment of treatment response. The current lack of standardized acquisition and analysis methods should be addressed to encourage more wide spread use of DCE-MRI in prostate cancer imaging.