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• Clinical Article •
Comparison of apparent diffusion coefficient and intravoxel incoherent motion imaging in stratification of prostate cancer: based on three-dimensional whole-tumor histogram analysis
ZHANG Pei-pei  WANG Liang  MIN Xiang-de  FENG Zhao-yan  KANG Zhen  LI Ba-sen  KE Zan  YOU Hui-juan 

DOI:10.12015/issn.1674-8034.2017.09.005.


[Abstract] Objective: To investigate the three-dimensional whole-tumor histogram analysis of apparent diffusion coefficients (ADCs) and IVIM-DWI in discriminating the Gleason grades of prostate cancer.Materials and Methods: A total of 57 patients with prostate cancer (PCa) underwent MRI before radical prostatectomy. DWI was acquired at 3.0 T using a single-shot echo-planar imaging sequence with 14 b values (0—1500 s/mm2). A volume of interest was drawn manually around every tumor visible on the images. The 10th, 25th, 50th, 75th, 90th, mean, min, kurtosis, skewness of ADC, D, D* and f were determined from a histogram that contained all voxels from all sections covering the entire tumor and correlated with the Gleason score (GS) by using the Spearman correlation coefficient (ρ). The patients were divided into GS≤3+4 and GS≥4+3 groups. The area under the receiver operating characteristic curve (AUC) was used to evaluate the ability of each parameter to differentiate the two groups.Results: GS≤3+4 in 23 cases (40.35%) and GS≥4+3 in 34 cases (59.65%). The 10th, 25th, 50th, 75th, 90th of ADC and D show a negative correlation with GS (ρ=-0.239—-0.411, P<0.05), and ρ values increased in turn. All above metrics were significantly different between two groups (P<0.05). The 90th ADC, 90th D show higher AUC (0.735 and 0.739, respectively) than mean ADC and mean D (0.719 and 0.698, respectively, P>0.05) in differentiating GS≤3+4 from GS≥4+3. There was no statistically significant difference between any two AUC values of ADC and D histogram metrics. The kurtosis of ADC and D were positively correlated with GS (ρ=0.357, P=0.006; ρ=0.350, P=0.008), but skewness had no correlation with GS. D* and f had no statistically significant correlation with GS either. The volume of whole-tumor lesion was positively correlated with GS (ρ=0.419, P=0.001), and showed a higher discriminatory performance (AUC=0.783) than ADC and D in differentiating GS≤3+4 from GS≥4+3.Conclusions: The histogram parameters of ADC and D had similar performance for prostate cancer stratification. D* and f were unable to distinguish between the different Gleason grades. Tumor volume may be a good predictor of PCa aggressiveness.
[Keywords] Prostatic neoplasms；Neoplasm grading；Diffusion magnetic resonance imaging

ZHANG Pei-pei Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

WANG Liang* Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

MIN Xiang-de Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

FENG Zhao-yan Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

KANG Zhen Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

LI Ba-sen Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

KE Zan Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

YOU Hui-juan Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China

*Correspondence to: Wang L, E-mail: wangliang_2001@yahoo.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This study was funded by the grant from National Natural Science Foundation of China No. 81171307, 81671656
Received  2017-04-19
Accepted  2017-08-06
DOI: 10.12015/issn.1674-8034.2017.09.005
DOI:10.12015/issn.1674-8034.2017.09.005.

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