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Diffusion-Kurtosis imaging predicts tumor upgrading in biopsy-proven Gleason score = 6 prostate cancers
Chen-Jiang Wu1, Yu-Dong Zhang1, and Hai-Bin Shi1

1Department of Radiology, the First Affiliated Hospital with Nanjing Medical University, Nanjing,China, People's Republic of China

Synopsis

The study investigated the feasibility of Diffusion Kurtosis Imaging (DKI) in predicting surgical result upgrading of biopsy-proven Gleason Score (GS) = 6 prostate cancer. The predicting efficiency of clinical variables (tumor volume, PSA level) and MRI variables (ADC, Dapp, Kapp) were compared by ROC analysis. DKI was found feasible to predict surgical result upgrading of biopsy-proven GS = 6 prostate cancer and Dapp-minimun had the highest Az value.

Purpose

To investigate whether Diffusion-Kurtosis (DK) Imaging is able to predict Gleason score (GS) upgrading in biopsy-proven GS = 6 prostate cancer (PCa).

Methods and Materials

A total of 46 patients who had biopsy-proven GS = 6 PCa, 3.0 T DWI (b value of 0-1400 s/mm2) results, and surgical pathological result were retrospectively included in the study. DWI data were post-processed by mono-exponential and DK models for quantitation of apparent diffusion coefficient (ADC), apparent diffusion for Gaussian distribution (Dapp), and apparent kurtosis coefficient (Kapp). The measurement was based on an entire-tumor approach. Volume of the lesions, prostate-specific antigen (PSA) and diffusion variables (minimum ADC [ADC-min], minimum Dapp [Dapp-min], maximum Kapp [Kapp-max] and mean ADC, Dapp, Kapp [ADC-mean, Dapp-mean, Kapp-mean]) were evaluated. The ability of these parameters to predict Gleason score (GS) upgrading was analyzed by receiver operating characteristic regression.

Results

The rate of GS upgrading was 50.0% (23/46). GS upgrading group showed significant lower ADC-min (P = 0.005), ADC-mean (P = 0.008), Dapp-min (P < 0.001), Dapp-mean (P = 0.001) and significant higher Kapp-max (P = 0.016), Kapp-mean (P = 0.029) and PSA (P=0.004) than non-upgrading group. The Dapp-min showed the highest values in Az (0.832; P < 0.05), Youden index (0.609) in all the parameters and the highest positive likelihood ratio (3.00) in all diffusion variables.

Conclusion

Our results showed that DK imaging may predict GS upgrading in biopsy-proven GS = 6 PCa. The Dapp-min had better diagnostic performance in predicting biopsy-proven GS = 6 PCa upgrading.

Acknowledgements

No acknowledgement found.

References

No reference found.

Figures

Fig.1. Gleason score upgrading group showed significant lower ADC-min, ADC-mean, Dapp-min, Dapp-mean and significant higher Kapp-max, Kapp-mean and PSA than non-upgrading group,respectively (P < 0.05).

Fig.2. Diagnostic performance of clinical, DWI and DKI variables. The Dapp-min showed the highest values in Az (0.832; P < 0.05), Youden index (0.609) in all the parameters and the highest positive likelihood ratio (3.00) in all diffusion variables.

Proc. Intl. Soc. Mag. Reson. Med. 25 (2017)
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