Objectives To evaluate multiparametric-MRI (mpMRI) derived
histogram textural-analysis parameters for detection of
transition zone (TZ) prostatic tumour.
Methods Sixty-seven consecutive men with suspected prostate
cancer underwent 1.5T mpMRI prior to template-mappingbiopsy
(TPM). Twenty-six men had ‘significant’ TZ tumour.
Two radiologists in consensus matched TPM to the single axial
slice best depicting tumour, or largest TZ diameter for those with
benign histology, to define single-slice whole TZ-regions-ofinterest
(ROIs). Textural-parameter differences between singleslice
whole TZ-ROI containing significant tumour versus
benign/insignificant tumour were analysed using Mann
Whitney U test. Diagnostic accuracy was assessed by receiver
operating characteristic area under curve (ROC-AUC) analysis
cross-validated with leave-one-out (LOO) analysis.
Results ADC kurtosis was significantly lower (p < 0.001) in
TZ containing significant tumour with ROC-AUC 0.80
(LOO-AUC 0.78); the difference became non-significant following
exclusion of significant tumour from single-slice
whole TZ-ROI (p = 0.23). T1-entropy was significantly lower
(p = 0.004) in TZ containing significant tumour with ROCAUC
0.70 (LOO-AUC 0.66) and was unaffected by excluding
significant tumour from TZ-ROI (p = 0.004). Combining
these parameters yielded ROC-AUC 0.86 (LOO-AUC 0.83).
Conclusion Textural features of the whole prostate TZ can
discriminate significant prostatic cancer through reduced kurtosis
of the ADC-histogram where significant tumour is included
in TZ-ROI and reduced T1 entropy independent of
tumour inclusion.
Key Points
• MR textural features of prostate transition zone may discriminate
significant prostatic cancer.
• Transition zone (TZ) containing significant tumour demonstrates
a less peaked ADC histogram.
• TZ containing significant tumour reveals higher postcontrast
T1-weighted homogeneity.
• The utility of MR texture analysis in prostate cancer merits
further investigation.