Xiaohang Liu1, Liangping Zhou1, Weijun Peng1, and Yong Zhang2
1Radiology, Fudan university shanghai cancer center, Shanghai, China, People's Republic of, 2MR Research China, GE healthcare, Beijing, China, People's Republic of
Synopsis
The
diffusion weighted imaging (DWI) is commonly used in the diagnosis of Prostate
cancer, but the cancer in Central gland (CG) is considered harder to detected on conventional DWI,but histogram analysis of apparent diffusion
coefficient
could potentially improve the differentiation of prostate cancer in CG. Purpose
The diffusion weighted imaging (DWI) is commonly used in the diagnosis of Prostate
cancer, but the cancer in Central gland (CG) is considered harder to detected on conventional DWI. The major obstacle to
identifying CG cancer comes from stromal hyperplasia (SH), which
showed a similar apparent diffusion
coefficient (ADC) value with CG cancer. Thus the purpose of this work was to investigate apparent diffusion coefficient (ADC) of prostate CG cancer
and SH with Histogram analysis, and to determine which ADC metric may help best
in the differentiation between the two tissues.
Materials and Methods
Twenty-eight
CG cancer foci and 34 SH nodules in the CG were analyzed in 54 patients (24
with CG cancer, 30 with peripheral zone cancer but no CG cancer) who underwent
preoperative DWI with single-shot spin-echo echo planar imaging (SS-EPI) sequence
(b-value 0, 1000 s/mm
2). All of the cancer and hyperplastic foci on MR images were localized on
the basis of histopathologic correlation. The 10th , 25th
and 50th and mean ADC value
of the were calculated for all of the lesions. The efficiency of 10th,
25 th and 50th for the differentiation of CG cancer from SH was
compared to ADC by Receiver operating characteristic (ROC) analysis.
Results
The 10th , 25 th and 50th and mean ADC values (×10
−3 mm
2/s)
were 0.87±0.13, 0.90±0.14, 0.96±0.15,1.06±0.16 in
SH and 0.63±0.12, 0.69±0.12, 0.72±0.15 and 0.82±0.15 in CG cancer, all the parameter were significantly
lower in CG cancer than SH(fig 1, table1 ). The 10th ADC yielded
areas under the ROC curve (AUCs) of 0.91 for the differentiation of carcinoma
and SH, which was higher than mean ADC(0.84), and the ROC of the 25th(0.86) and 50th(0.85) showed no difference from ADC(fig
2).
Conclusion and discussion
The low ADC value in
cancer was mainly due to the increased cells and the destruction of acinar, thus
a more dense structure, and less free fluid. There is an increase in the
stromal component and reduce in the acinar component in SH, which also limit
the diffusion of water. The 10% ADC may mainly reflect the diffusion of stromal
tissue in SH, and densely packed malignant cells in cancer, which avoid some confusion
improve the distinguishing of the SH and cancer. In summary, histogram analysis
of apparent diffusion coefficient could potentially improve the differentiation
of prostate cancer in CG.
Acknowledgements
No acknowledgement found.References
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et al. Prostate cancer aggressiveness: assessment with whole-lesion histogram
analysis of the apparent diffusion coefficient[J].
Radiology,2014,271(1):143-152.
[2] Lin Y, Li H, Chen Z, et al. Correlation of histogram analysis of apparent
diffusion coefficient with uterine
cervical pathologic finding. AJR Am J Roentgenol 2015;204(5):1125-1131.