MR measurements of luminal water in prostate gland
Shirin Sabouri1, Ladan Fazli2,3, Silvia Chang4,5, Richard Savdie3, Edward Jones6, Larry Goldenberg2,3, and Piotr Kozlowski2,3,4,7

1Physics and Astronomy, University of British Columbia, Vancouver, BC, Canada, 2Vancouver Prostate Centre, Vancouver, BC, Canada, 3Urologic Sciences, University of British Columbia, Vancouver, BC, Canada, 4Radiology, University of British Columbia, Vancouver, BC, Canada, 5Vancouver General Hospital, Vancouver, BC, Canada, 6Pathology, Vancouver General Hospital, Vancouver, BC, Canada, 7UBC MRI Research Center, Vancouver, BC, Canada

Synopsis

Measurement of relative amount of lumen in prostatic tissue can provide useful information for diagnosing of many prostatic diseases. Using multi-exponential T2 mapping, the fractional volume of the luminal space, or so called luminal water fraction (LWF), in the prostatic tissue can be determined. In order to use the LWF as a proportional representative of the true percentage of lumen, it is important to investigate the correlation between the two parameters. We have acquired and analyzed MR images of 10 subjects, and found a significant correlation between the LWF and the percentages of lumen in tissue.

Target Audience

Clinicians and researchers interested in characterization of prostatic tissue

Purpose

To explore the relationships between MR measurements from multi-exponential T2 mapping and the underlying tissue composition in prostate

Introduction

MR multi-exponential T2 mapping is a well-known imaging technique that has been applied for tracking histo-pathological changes in organs such as brain1. This technique can also be used for extracting valuable information about tissue composition in prostate. In the glandular tissue of prostate T2 decay is bi-exponential, with two distinguishable T2 relaxation times2. A longer T2 component is related to the water protons residing inside the lumen, while a shorter T2 component is related to the water protons residing within the epithelial and stromal tissue (see Figure 1). Using multi-exponential T2 mapping, the fractional volume of the luminal space, or so called luminal water fraction (LWF), in the prostatic tissue can be determined. In this study, we hypothesized that the LWF measured with MRI correlates with the true percentage of lumen in the­­ tissue. To validate this hypothesis, we have acquired and analyzed MR images of 10 subjects, and evaluated the correlation between MR measurements and the true percentages of underlying tissue compositions. Particularly, we evaluated the correlation between LWF and the percentage of lumen in tissue.

Methods

Data acquisition was carried out at the University of British Columbia (UBC) MRI Research Centre, using a 3.0T whole body MR scanner [Achieva 3.0T, Philips Medical Systems, Best, The Netherlands]. Ten patients with biopsy proven cancer underwent MRI scan with an endorectal coil, prior to undergoing prostatectomy. A 3D multi-echo spin echo sequence (TR/TE=3061/25ms, NE=64, FOV=240x240x40mm3, voxel-size=1x1x4mm3, matrix-size=240x240) was used for scanning of the entire prostate gland. Images were analyzed with Matlab [The MathWorks Inc,Natick, MA, USA]. The analysis involved regularized Non-Negative Least Squares (NNLS)3,4 fitting of multi-exponential decay curves, which generated T2 distributions for every pixel (see Figure 2). The following parameters were defined and used to describe the T2 distribution of each pixel: number of distinguishable T2 components (N) determined by counting the number of peaks in the distribution; geometric mean of the short (T2-short) and long (T2-long) components, as well as the geometric mean of the entire distribution (gmT2); ratio of area under the long component over the total area under the entire distribution (LWF); and areas under the short (A1) and long (A2) components. Average values of these parameters were calculated within 211 ROIs manually outlined on digitized images of the whole-mount histology sections with histologic resolution, registered to MRI images5. Percentage area of tissue components including lumen, nuclei, and epithelial cytoplasm plus stroma, were measured on digitized whole mount histology sections by using image segmentation with DIH software [Leica Microsystems Inc., Germany] (see Figure 3). Statistical analyses were performed with MedCalc [MedCalc Software, Mariakerke, Belgium]. Correlations between MR parameters and percentage area of tissue components were evaluated with Spearman’s rank correlation test.

Results and Discussions

A2, LWF, T2-short, gmT2, and N significantly correlated with the percentage of lumen, with the highest correlation obtained for LWF (0.809, p<0.001); Figure 4 demonstrates the scattered diagram of LWF versus area percentage of lumen. Area percentage of nuclei did not have significant correlation with any of the MR parameters, with the exception of A1 (0.387, p<0.001). Finally, the area percentage of epithelial cytoplasm plus stroma had significant correlation with A2, LWF, T2-short, and gmT2, with the highest correlation obtained for gmT2 (-0.639, p<0.001). In conclusion, the results of this pilot study demonstrate that LWF measured with MRI is significantly correlated with the percentage area of lumen in the prostatic tissue. Therefore, the methodology established in this study for measuring LWF, may be useful in diagnosing various prostatic diseases, including prostate cancer, in which the amounts of lumen differs between normal and abnormal tissues.

Acknowledgements

This study has been supported by the Canadian Institutes of Health Research. The authors thank Dr. Antonio Hurtado for his assistance in statistical analysis of digitized whole-mount histology sections.

References

[1] MacKay A, et al. Magn Reson Med 1994;31:673–677. [2] Storås T. H., et al. J. Magn. Reson. Imaging. 2008;28:1166–1172. [3] Bjarnason TA., Mitchell JR. J Magn Reson 2010;206:200–4. [4] Prasloski T., et al. Magn Reson Med. 2012;67(6):1803-14. [5] Uribe CF et al., Magn. Reson. Imaging, 2015;33:577-583.

Figures

A section of normal human prostatic tissue (20×) from PZ.

NNLS fitting of a multi-exponential T2 signal decay curve (left-hand side), and its corresponding T2 distribution (right-hand side). This data is from a single pixel in the peripheral zone.

Representative example of segmentation of whole mount histologic images. A) A magnified (20×) hematoxylin-eosin–stained section . B) Tissue components are segmented into stroma plus epithelial cytoplasm (blue), lumen (yellow), and nuclei (orange).

Scattered diagram of LWF versus percentage area of lumen.



Proc. Intl. Soc. Mag. Reson. Med. 24 (2016)
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