Synopsis

To evaluate the value of the (kurtosis, perfusion and diffusion) parameters in the differentiation of TZ cancer from benign GH.30 patients underwent preoperative 3-T magnetic resonance (MR) imaging. Each parameter in TZ carcinomas and GH were compared using Student's t test, receiver operating characteristics (ROC) analysis. All parameters except for D* in TZ carcinoma and GH were significantly different, and showed the same sensitivity for differentiating TZ carcinoma from GH (92.3%), and K and ADCs with equal specificity (96.7%).The monoexponential ultra-high b value ADC calculation is more practical to discriminate TZ carcinoma from GH.

Purpose: To analyze the (kurtosis, perfusion and diffusion) parameters of transition zone (TZ) prostate cancer, and glandular hyperplasia (GH) and to determine the role of these parameters in the differentiation of TZ cancer from benign TZ hyperplasia. Materials and Methods: 13 foci of carcinoma, 30 GH nodules in the TZ were analyzed in 30 patients (13 with CG carcinoma) who underwent preoperative 3-T magnetic resonance (MR) imaging by using a pelvic phased-array coil, including diffusion kurtosis imaging (DKI) (b values 0, 1000, and 3000s/mm² ), Intravoxel Incoherent motion(IVIM) (12 b values range from 50 to 3000s/mm² ) , and ultra-high b-value DW imaging (DWI) (b values 0, 3000s/mm² ). The metric K (K), corrected diffusion (D_corrected), true diffusion coefficient (D), perfusion fraction (f), pseudo-diffusion coefficient (D*), and apparent diffusion coefficient (ADC) for all carcinoma, and GH foci were calculated. Each parameter in TZ carcinomas and GH were compared using Student's t test, receiver operating characteristics (ROC) analysis. Z test was performed for compare area under the ROC curves (AUCs) of each parameter. Results: K was significantly greater in TZ carcinoma than in GH (1.14 ± 0.19 vs 0.69 ± 0.12, P<0.001). The Dcorrected (×10 -3mm2/s), ADCs (×10^-3mm²/s), D(×10 ^-3mm²/s), and f in carcinoma were significantly lower than those found in GH (0.87±0.19 vs 1.51 ± 0.34, 0.475 ± 0.08 vs 0.73 ± 0.13, 0.39 ± 0.06 vs 0.53 ± 0.10×10, 0.30 ± 0.10 vs 0.53 ± 0.15, P<0.001). D* (×10 ^-3mm²/s) in TZ carcinoma and GH was not significantly different (5.68 ± 3.52 vs 4.19 ± 1.82, P=0.072). ROC analysis demonstrated a higher area under the ROC curve value for all parameters except D* in differentiating TZ carcinoma from GH (0.890-0.967; P>0.05). All parameters except for D* showed the same sensitivity for differentiating TZ carcinoma from GH (92.3%), and K and ADCs with equal specificity (96.7%). Conclusion: Preliminary findings suggest the performance of DKI, IVIM, and ultra-high b value DWI were equivalent in differentiating TZ carcinoma from GH , with DKI and ultra-high b value DWI having higher sensitivity than IVIM without reaching significance. The monoexponential ultra-high b value ADC calculation is sufficient to discriminate TZ carcinoma from GH.

Acknowledgements

References

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