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• Clinical Article •
Differential diagnosis of MRI apparent diffusion coefficient for high-risk prostate cancer in the transition zone and its correlation with pathological grading group
LI Peng  LI Yan  XU Jie  JING Li 

Cite this article as: LI P, LI Y, XU J, et al. Differential diagnosis of MRI apparent diffusion coefficient for high-risk prostate cancer in the transition zone and its correlation with pathological grading group[J]. Chin J Magn Reson Imaging, 2024, 15(2): 77-82, 89. DOI:10.12015/issn.1674-8034.2024.02.011.


[Abstract] Objective To investigate the differential diagnostic value of apparent diffusion coefficient (ADC) and relative ADC values of diffusion weighted imaging (DWI) for high-risk prostate cancer (hPCa) in the transition zone and their correlation with International Society of Urological Pathology (ISUP) grading group (GG).Materials and Methods Retrospective analysis was performed on biparametric MRI data from 40 patients with transition zone prostate cancer confirmed by pathology. This analysis involved measuring the mean ADC (ADCmean) and minimum ADC (ADCmin) of transition zone prostate cancer and stromal hyperplastic nodules. Additionally, it calculated the relative ADCmean (rADCmean) and relative ADCmin (rADCmin), defined as the ratio of ADC values between transition zone carcinoma foci and stromal hyperplastic nodules. The receiver operating characteristic (ROC) curve was used to assess the diagnostic efficacy of each ADC parameter for hPCa in the transition zone and to determine the optimal cutoff value based on the Youden's index. DeLong's test was used to compare the differences in area under the curve (AUC) of the ROC curve. Spearman correlation analysis was performed to analyze the correlation between each of the ADC parameters and ISUP GG.Results The values of ADCmean, ADCmin, rADCmean and rADCmin in the hPCa group were lower than those in the lPCa group (all P<0.05). The AUCs for the differential diagnosis of hPCa in the transition zone were 0.775 [95% confidence interval (CI): 0.615-0.892]、0.879 (95% CI: 0.736-0.960)、0.751 (95% CI: 0.589-0.874) and 0.914 (95% CI: 0.782-0.979) for ADCmean, ADCmin, rADCmean and rADCmin, respectively. The maximum AUC was observed with rADCmin. rADCmin showed statistically significant differences in AUC compared to both ADCmean and rADCmean (all P<0.05), but not with ADCmin (P>0.05). When the optimal cutoff value of rADCmin was taken as 0.664×10-3 mm2/s with the highest Youden's index (0.783), the sensitivity and specificity of diagnosing hPCa in the transition zone were 100.00% and 78.26%, respectively. ADCmean, ADCmin, rADCmean and rADCmin values were all negatively correlated with ISUP GG [r=-0.486 (95% CI: -0.755--0.151), -0.613 (95% CI: -0.769--0.365), -0.553 (95% CI: -0.745--0.260) and -0.678 (95% CI: -0.810--0.474, all P≤0.001].Conclusions The efficacy of rADCmin in differential diagnosing hPCa in the transition zone was high. rADCmin was able to noninvasively predict ISUP GG of PCa in the transition zone, which can help to provide personalized treatment decision support for patients.
[Keywords] prostate neoplasms；prostate hyperplasia；transition zone；magnetic resonance imaging；apparent diffusion coefficient；grading group

LI Peng1, 2   LI Yan1   XU Jie2   JING Li2*  

1 Department of Radiology, General Hospital of Ningxia Medical University, Yinchuan 750004, China

2 Department of Pathology, School of Basic Medical Science, Ningxia Medical University, Yinchuan 750004, China

Corresponding author: JING L, E-mail: jinglinxmu@163.com

Conflicts of interest   None.

Received  2023-11-20
Accepted  2024-01-20
DOI: 10.12015/issn.1674-8034.2024.02.011
Cite this article as: LI P, LI Y, XU J, et al. Differential diagnosis of MRI apparent diffusion coefficient for high-risk prostate cancer in the transition zone and its correlation with pathological grading group[J]. Chin J Magn Reson Imaging, 2024, 15(2): 77-82, 89. DOI:10.12015/issn.1674-8034.2024.02.011.

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