The predictive value of DCE-MRI and DWI for Ki-67 expression and Gleason score in prostate cancer

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• Clinical Article •

ZHOU Dingyan HE Wenqi WANG Wei CHEN Meining LUO Min

Cite this article as: ZHOU D Y, HE W Q, WANG W, et al. The predictive value of DCE-MRI and DWI for Ki-67 expression and Gleason score in prostate cancer[J]. Chin J Magn Reson Imaging, 2024, 15(9): 94-100, 119. DOI:10.12015/issn.1674-8034.2024.09.016.

Abstract

[Abstract] Objective To evaluate the diagnostic efficacy of dynamic contrast enhancement magnetic resonance imaging (DCE-MRI) combined with diffusion weighted imaging (DWI) in predicting Ki-67 expression and Gleason score in prostate cancer (PCa) Ki-67 expression and Gleason score.Materials and Methods A retrospective analysis of MRI data from 66 PCa patients treated at the Zigong Fourth People's Hospital from January 2019 to October 2023 was conducted. Combining T2WI, DWI sequences and the apparent diffusion coefficient (ADC) automatically calculated by DWI, the regions of interest (ROI) of the tumor was manually outlined on the DCE-MRI images, calculate ROI pharmacokinetic parameters, including volumetric transport constants (K^trans), rate constant (Kep), extravascular extracellular volume fraction (Ve), and measure apparent diffusion coefficient values (ADC). According to the targeted puncture pathology diagnosis Gleason score and Ki-67 expression level were categorized into Ki-67 high expression group (Ki-67>10%) and low expression group (Ki-67≤10%), and Gleason score low grade (GG 1-2) and high grade (GG 3-5) groups. Differences between groups were compared using two independent samples t-test or non-parametric test, Spearman correlation analysis was used to evaluate the correlation of DCE-MRI parameters and ADC values with Ki-67 and Gleason scores, and logistic regression model was established to evaluate the diagnostic efficacy by receiver operating characteristic (ROC) curve to evaluate the diagnostic efficacy.Results ADC values in PCa were negatively correlated with Ki-67 expression and Gleason score (P<0.001), while K^trans, Kep and Ve were positively correlated with Ki-67 expression (P<0.001). K^trans and Kep were also positively correlated with Gleason score (P<0.001). Statistically significant differences were found in K^trans, Kep, Ve and ADC values between high and low Ki-67 expression groups (P<0.01), as well as between high and low Gleason score groups (P<0.01). ROC curve analysis for Ki-67 expression showed that the combined model of K^trans+Kep+Ve+ADC had the best diagnostic performance, with an area under the curve (AUC) of 0.940. ROC curve analysis for Gleason score grading showed that the combined model of K^trans+Kep+ADC had the best diagnostic performance, with an AUC of 0.861.Conclusions The quantitative parameters of DCE-MRI combined with ADC values show high diagnostic efficacy in predicting Ki-67 expression and Gleason score in PCa. These findings suggest that the combined use of quantitative DCE-MRI parameters with ADC values improves the accuracy of predicting pathological grading and biological aggressiveness of PCa.

[Keywords] prostate cancer；Ki-67；Gleason score；magnetic resonance imaging；dynamic contrast-enhanced；diffusion weighted imaging

Contributor Information

ZHOU Dingyan¹ HE Wenqi² WANG Wei² CHEN Meining³ LUO Min^2*

¹ Department of Radiology, Affiliated Hospital of Southwest Medical University, Luzhou 646000, China

² Department of Radiology, Zigong Fourth People's Hospital, Zigong 643000, China

³ Department of MR Scientific Marketing, Siemens Healthineers, Shanghai 200124, China

Corresponding author: LUO M, E-mail: zghd1234@163.com

Conflicts of interest None.

Publication Information

Received 2024-04-30

Accepted 2024-09-10

DOI: 10.12015/issn.1674-8034.2024.09.016

Text

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