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• Clinical Article •
The value of mono-exponential, bi-exponential and stretched exponential DWI models in identifying prostate cancer and stromal prostate hyperplasia
WU Hui  WU Jing  YU Na  QIAN Luodan  YU Xiaoyu  JIA Yushan  GAO Yang  NIU Guangming 

Cite this article as: Wu H, Wu J, Yu N, et al. The value of mono-exponential, bi-exponential and stretched exponential DWI models in identifying stromal prostate cancer and stromal prostate hyperplasia. Chin J Magn Reson Imaging, 2020, 11(7): 546-551. DOI:10.12015/issn.1674-8034.2020.07.014.


[Abstract] Objective: To compare the value of various diffusion parameters obtained from monoexponential, biexponential, and stretched exponential diffusion-weighted imaging (DWI) models in identification of prostate cancer and prostate hyperplasia.Materials and Methods: Retrospective analysis of puncture biopsy confirmed prostate cancer (PCa) 28 cases, stromal prostate hyperplasia (SH) 22 cases of clinical data. All patients underwent T2WI, T1WI, DWI, multi-b DWI scan. According to the results of puncture pathology to determine the location of cancer or hyperplasia, with DWI and multi-b value DWI images to match. ADC, D, D*, f and DDC, α values were measured in PCa group and SH group. Differences were compared using independent t test, receiver operating characteristic (ROC) to differentiate the diagnostic efficacy, Correlation analysis using Sperman or Pearson.Results: (1) ADC, D, DDC, α were lower in the PCa group (0.72±0.14×10-3 mm2/s, 0.57±0.11×10-3 mm2/s, 0.71±0.14×10-3 mm2/s, 0.63±0.03) than in the SH group (1.14±0.13×10-3 mm2/s, 0.94±0.12×10-3 mm2/s, 1.30±0.17×10-3 mm2/s, 0.76±0.05) the difference was statistically significant. D* was higher in the PCa group (17.96±13.39×10-3 mm2/s) than in the SH group (10.28±4.96×10-3 mm2/s), the difference was statistically significant. f was slightly higher in the PCa group (0.30±0.08) than in the SH group (0.29±0.05) , the difference was no statistically significant. (2) DDC, D, ADC, α all have higher diagnostic performance, the area under the curve (AUC) values were 0.9961, 0.9957, 0.9903, 0.9573 respectively; the diagnostic threshold were 0.97×10-3, 0.70×10-3, 0.86×10-3, 0.69. (3) ADC, D, DDC have good correlation both in PCa and SH groups. The PCa group had the strongest correlation with ADC and DDC, the coefficient r=0.852; the correlation between ADC and D was the strongest in SH group, the correlation coefficient r=0.751.Conclusions: DDC, α calculated from stretched exponential model, D calculated from bi-exponential model and ADC calculated from mono-exponential model in the identifying prostate cancer and stromal prostate hyperplasia all have high performance. MRI has obvious advantages in the diagnosis and differential diagnosis of PCa, and different DWI models become its beneficial supplements, the bi-exponential model can provide perfusion information, the stretched exponential model can provide diffusion heterogeneity information. However, the diagnostic performance of the biexponential model and the stretched exponential model is not higher than the traditional monoexponential model, so DWI is still recommended in clinical practice.
[Keywords] prostatic neoplasms；prostatic hyperplasia；magnetic resonance imaging；diagnosis, differential

WU Hui Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China

WU Jing Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China

YU Na Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China

QIAN Luodan Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China

YU Xiaoyu Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China

JIA Yushan Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China

GAO Yang* Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China

NIU Guangming* Department of Radiology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, China

*Correspondence to: Niu GM, E-mail: cjr.niuguangming@vip.163.com; GaoY, E-mail: 1390903990@qq.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This article was supported by the Natural Science Foundation of Inner Mongolia No. 2017MS (LH) 0837
Received  2019-10-25
Accepted  2020-03-23
DOI: 10.12015/issn.1674-8034.2020.07.014
Cite this article as: Wu H, Wu J, Yu N, et al. The value of mono-exponential, bi-exponential and stretched exponential DWI models in identifying stromal prostate cancer and stromal prostate hyperplasia. Chin J Magn Reson Imaging, 2020, 11(7): 546-551. DOI:10.12015/issn.1674-8034.2020.07.014.

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