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Blood oxygenation level-dependent magnetic resonance imaging during carbogen breathing: differentiation between prostate cancer and benign prostate hyperplasia and correlation with vessel maturity

Authors Di N, Mao N, Cheng W, Pang H, Ren Y, Wang N, Liu X, Wang B

Received 31 January 2016

Accepted for publication 8 April 2016

Published 7 July 2016 Volume 2016:9 Pages 4143—4150


Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Manfred Beleut

Peer reviewer comments 2

Editor who approved publication: Professor Min Li

Ningning Di,1,2,* Ning Mao,3,* Wenna Cheng,4 Haopeng Pang,1 Yan Ren,1 Ning Wang,2 Xinjiang Liu,2 Bin Wang5

1Department of Radiology, Affiliated Huashan Hospital of Fudan University, Shanghai, 2Department of Radiology, Binzhou Medical University Affiliated Hospital, Binzhou, 3Department of Radiology, Yantai Yuhangding Hospital, Yantai, 4Department of Pharmacy, Binzhou Medical University Affiliated Hospital, Binzhou, 5Department of Medical Imaging and Nuclear Medicine, Binzhou Medical University, Yantai, People’s Republic of China

*These authors contributed equally to this work

Objective: The aim of this study was to investigate whether the blood oxygenation level-dependent (BOLD) contrast magnetic resonance imaging (MRI) can evaluate tumor maturity and preoperatively differentiate prostate cancer (PCa) from benign prostate hyperplasia (BPH).
Patients and methods: BOLD MRI based on transverse relaxation time*-weighted echo planar imaging was performed to assess PCa (19) and BPH (22) responses to carbogen (95% O2 and 5% CO2). The average signal values of PCa and BPH before and after carbogen breathing and the relative increased signal values were computed, respectively. The endothelial-cell marker, CD31, and the pericyte marker, α-smooth muscle actin (mature vessels), were detected with immunofluorescence, and were assessed by microvessel density (MVD) and microvessel pericyte density (MPD). The microvessel pericyte coverage index (MPI) was used to evaluate the degree of vascular maturity. The changed signal from BOLD MRI was correlated with MVD, MPD, and MPI.
Results: After inhaling carbogen, both PCa and BPH showed an increased signal, but a lower slope was found in PCa than that in BPH (P<0.05). PCa had a higher MPD and MVD but a lower MPI than BPH. The increased signal intensity was positively correlated with MPI in PCa and that in BPH (r=0.616, P=0.011; r=0.658, P=0.002); however, there was no correlation between the increased signal intensity and MPD or MVD in PCa than that in BPH (P>0.05).
Conclusion: Our results confirmed that the increased signal values induced by BOLD MRI well differentiated PCa from BPH and had a positive correlation with vessel maturity in both of them. BOLD MRI can be utilized as a surrogate marker for the noninvasive assessment of the degree of vessel maturity.

Keywords: BOLD, magnetic resonance imaging, prostate carcinoma, benign prostate hyperplasia, vessel maturity

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