Comparison of Early Contrast Enhancement Models in Ultrafast Dynamic Contrast-Enhanced Magnetic Resonance Imaging of Prostate Cancer.

Tofts models have failed to produce reliable quantitative markers for prostate cancer. We examined the differences between prostate zones and lesion PI-RADS categories and grade group (GG) using regions of interest drawn in tumor and normal-appearing tissue for a two-compartment uptake (2CU) model (including plasma volume (v), plasma flow (F), permeability surface area product (PS), plasma mean transit time (MTT), capillary transit time (T), extraction fraction (E), and transfer constant (K)) and exponential (amplitude (A), arrival time (t), and enhancement rate (α)), sigmoidal (amplitude (A), center time relative to arrival time (A - T), and slope (A)), and empirical mathematical models, and time to peak (TTP) parameters fitted to high temporal resolution (1.695 s) DCE-MRI data. In 25 patients with 35 PI-RADS category 3 or higher tumors, we found F and α differed between peripheral and transition zones. Parameters F, MTT, T, E, α, A - T, and A and TTP all showed associations with PI-RADS categories and with GG in the PZ when normal-appearing regions were included in the non-cancer GG. PS and K were not associated with any PI-RADS category or GG. This pilot study suggests early enhancement parameters derived from ultrafast DCE-MRI may become markers of prostate cancer.