Fig 1.
Digitalized prostate histopathology.
A, B: Histologic prostate tissue sections (x10 objective) from regions of PZ tumor tissue with a Gleason grade of 3. Each H&E stained whole-mount section was digitalized at x20 resolution (A). The digitalized slide was then segmented, using a positive pixel counting algorithm, into three main tissue components (B): cellularity (orange and yellow), fibromuscular stromal matrix (FSM, blue), and luminal space (white). This Gleason grade 3 region has limited luminal space and is highly cellular; the malignant glandular architecture is infiltrating into the surrounding FSM. C, D: The H&E stained whole-mount section from a primarily Gleason grade 4 region (C) was also digitalized at x20 resolution and segmented (D). This Gleason grade 4 region shows complex architecture with limited luminal space and malignant cellularity, which has extensively infiltrated and almost completely replaced the FSM.
Table 1.
Patient Characteristics.
Table 2.
Fractional areas of tissue components for peripheral zone tumors and normal prostate.
Fig 2.
Image segmentation and DKI in a GS 4+5 right PZ tumor.
MR imaging (A-C) and corresponding histopathological sections (D-F) from a 64 year-old man with Gleason score 4+5 prostate cancer (defined by white region of interest in A-D) and a pre-operative prostate-specific antigen (PSA) level of 6.7 ng/mL. A: Axial T2W-MRI shows a right peripheral zone tumor visible due to its low signal intensity compared to the surrounding peripheral zone. B: The axial Dapp map (b-values of 150, 750, 1000, 1500 s/mm2) shows highly restricted diffusion within the tumor ROI with a median Dapp of 1.08 x 10−3 mm2/s. C: Axial Kapp map shows increased diffusional kurtosis in the tumor ROI with a median Kapp of 1.28 (scale bar shown). D: H&E stained slide (x0.2 objective) shows a region of GS 4+5 tumor, which corresponds to the tumor ROI shown on MRI. E, F: Image segmentation (x0.5 and x10 objectives respectively) shows a highly aggressive tumor with the following fractional tissue composition: 0.61 cellularity; 0.32 FSM; 0.07 luminal space.
Table 3.
DKI quantitative measures for peripheral zone tumors and normal prostate.
Table 4.
Correlation between the fractional areas of each tissue component and the two quantitative DKI parameters.