Your Donations in Action: Sree Harsha Tirumani, MD

MR fingerprinting for predicting clinically significant prostate cancer

head shot of Sree Harsha Tirumani, MD
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The Prostate Imaging Reporting and Data System (PI-RADS) version 2.1 assigns a score of 3 (PI-RADS 3) for lesions with intermediate-likelihood for clinically significant prostate cancer. Studies have shown that only up to 20% of PI-RADS 3 lesions harbor clinically significant prostate cancer while the remaining 80% have no or clinically insignificant cancer.

MR fingerprinting (MRF) is a novel imaging technique which allows rapid accurate quantification of tissue T1 and T2 relaxation times. In turn, these values can be used for rapid quantitative analysis of pathologic conditions.

For his 2020 RSNA Research Scholar Grant, “Integrating ADC Values and MR Fingerprinting with Clinical Parameters in the Evaluation of PI-RADS 3 Lesions: Utility in Predicting Clinically Significant Prostate Cancer,” Sree Harsha Tirumani, MD, associate professor of radiology at Case Western Reserve University (CWRU) in Cleveland, sought to use MR fingerprinting to characterize equivocal focal lesions in prostate MRI.

Preliminary studies conducted at CWRU have shown that a combination of apparent diffusion coefficient (ADC) and MRF-derived T1 and T2 values can separate clinically significant prostate cancer and clinically insignificant cancer in both the peripheral and transition zones.

Dr. Tirumani and colleagues prospectively evaluated the utility of integrating ADC and MR fingerprinting with clinical parameters, including age, race and PSA density, to develop a decision analysis model for predicting clinically significant prostate cancer in PI-RADS 3 lesions using histopathology from MR-transrectal US fusion or MR-guided in-gantry biopsy as gold standard.

“The anticipated clinical use will be to differentiate cancer from non-cancerous lesions which will aid in biopsy decision process,” Dr. Tirumani said.

The R&E Foundation grant assisted Dr. Tirumani in his growth as a clinical researcher and in fostering collaborations at his institution.

“The grant provided the opportunity to interact with our biomedical engineering MR research faculty as well as the urology colleagues and build an integrated research team,” Dr. Tirumani said. “More importantly, the grant helped us develop research work flows and mechanism which will serve as templates for future researchers in our institution.”

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Read our previous Your Donations in Action article.