PONE-D-22-32433Optimal length and temporal resolution of dynamic contrast-enhanced MR imaging for the differentiation between prostate cancer and normal peripheral zone tissuePLOS ONE

Dear Dr. Hellstern,

Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process.

1. Provide the details of the radiological pathological correlation and how they differentiated prostate cancer tissue and normal prostate tissue.
2. Please provide other prostate MRI findings in addition to the DCE-MRI.
3. Please compare the non-parametric semiquantitative method with the quantitative method.

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Academic Editor

PLOS ONE

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"I have read the journal's policy and the authors of this manuscript have the following competing interests:

Marius Hellstern has nothing to disclose. Christopher Wallenhorst and Carlos Martinez employees of the Institute for Epidemiology, Statistics and Informatics GmbH. The Institute for Epidemiology, Statistics and Informatics GmbH has received grants from Bayer, Bristol-Myers Squibb and CSL Behring outside the submitted work. Marc-Oliver Grimm and Ulf Teichgräber have nothing to disclose. Tobias Franiel receives financial support from Zentrales Innovationsprogramm Mittelstand des Bundesministeriums für Wirtschaft und Energie (ZF4816001BA9), personal fees from Bayer AG, Medac GmbH and Saegeling Medizintechnik GmbH and royalties from Georg Thieme Verlag. Tobias Franiel serves on the advisory board of Bayer AG and is a member of the committee of German S3 guideline for prostate cancer. Dirk Beyersdorff has nothing to disclose. Lutz Lüdemann has nothing to disclose."

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Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Partly

Reviewer #2: Partly

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2. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

Reviewer #2: Yes

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3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

Reviewer #2: Yes

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4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

Reviewer #2: Yes

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5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Thank you very much for selecting me as a reviewer for the article “Optimal length and temporal resolution of dynamic contrast-enhanced MR imaging for the differentiation between prostate cancer and normal peripheral zone tissue”.

This paper deals with very interesting topic of dynamic contrast-enhanced magnetic resonance which is an insufficiently used method and there is a great scientific interest in increasing usability of this method. Problem with the DCE-MRI is lack of standardisation between institutions.

The authors stated that “There are currently insufficient peer reviewed published data or expert consensus to support routine adoption of DCE-MRI for clinical use“ which is only partially correct. DCE-MRI is included in all PI RADS version. According to currently valid PI RADS v2.1 DCE-MRI is used as quantitative method so it is in clinical use. There is insufficient data on semiquantitative and quantitative DCE-MRI, that is , there is a need for research that presents the superiority of these two methods and research that deals with the standardisation of these methods.

Also the authors, through the abstract, introduction and discussion, conclude about the superiority of the non-parametric semiquantitative method compared to the quantitative method, however, as they stated in the limitations of the research, they did not compare the two methods.

There are many research, not only regarding prostate but also many other organ systems, published in high quality journals that support use of quantitative method od DCE-MRI wherever possible. Quantitative study by observing the movement of contrast medium between intra- and extravascular space gives information about tumour angiogenesis so it has a role not only in locoregional staging of the disease or potential role in PI RADS categorisation but also in monitoring of oncologic treatment response.

Methodology is explained in detail, which is the major strength of this manuscript in order to guide further research on this topic. The research is conceptually designed and developed with high quality.

The results are certainly of great value in directing further research.

I hope my comment would be of help for the authors to make their study more suitable for publication.

Thank you.

Reviewer #2: The aim of the study is assessing the optimal temporal resolution and measurement lenght for

DCE-MRI for differentiating peripheral prostate cancer and normal prostate gland. The

authors emerged that the study cohort is consisted of patients with who underwent prostate

MRI before radical prostatectomy. They use onset time, relative signal intensity (RSI), wash-

in slope, peak enhancement, wash-out and wash-out slope as predictors of interest that

determined from non-parametric characterisation of DCE-MRI intensity- time profiles. A C-

statistics based on cross validation were performed to esmimate the discriminatory power.

The Authors stated that DCE-MRI settings of 2.5 minutes measurement length and 8.0

seconds temporal resolution are most appropriate to identify prostate cancer in the peripheral

zone.

The strong aspects of this study is as follows:

- The aim of this study is to evaluate for optimal DCE-MRI parameters, which is a

simple and fundamental need.

- There is no study in the literature evaluating optimal remporal resolution and

measurement length.

However, this study has some major shortcomings.

- To give optimal values, the number of study chort that was conducted from 54 patients

with 97 prostate tissue specimens (47 prostate cancer, 50 normal prostate tissue) of the

peripheral zone is insufficient.

- DCE-MRI is not a dominant sequence in prostate MRI evaluation and should always

be read in conjunction with the other MRI sequences. However, the authors do not

mention other prostate MRI findings in the article.

- The authors did not explain how they made the radiological pathological correlation

and how they differentiated prostate cancer tissue and normal prostate tissue.

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​

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Reviewer #1: No

Reviewer #2: No

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Submitted filename: PLOS ONE review.docx

Optimal length and temporal resolution of dynamic contrast-enhanced MR imaging for the differentiation between prostate cancer and normal peripheral zone tissue

PONE-D-22-32433R1

Dear Dr. Hellstern,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Lorenzo Faggioni, M.D., Ph.D.

Academic Editor

PLOS ONE

Additional Editor Comments (optional):

Thank you for your reply.

Reviewers' comments:

Reviewer's Responses to Questions

Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.

Reviewer #1: All comments have been addressed

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2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented.

Reviewer #1: Yes

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3. Has the statistical analysis been performed appropriately and rigorously?

Reviewer #1: Yes

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4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.

Reviewer #1: Yes

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5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.

Reviewer #1: Yes

**********

6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)

Reviewer #1: Dear Authors and Editor,

I am very satisfied with the corrections that authors have made and with detailed answers they have given to the reviewer’s comments.

Sincerely.

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7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.

Reviewer #1: No

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