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• Clinical Articles •
The value of APTw imaging in the differential diagnosis of prostatic diseases
CHEN Lihua  WANG Siqi  ZHANG Yumeng  SONG Qingwei  LIN Liangjie  WANG Jiazheng  ZHANG Qinhe  LIU Ailian 

Cite this article as CHEN L H, WANG S Q, ZHANG Y M, et al. The value of APTw imaging in the differential diagnosis of prostatic diseases[J]. Chin J Magn Reson Imaging, 2026, 17(8): 98-106. DOI:10.12015/issn.1674-8034.2026.08.010.


[Abstract] Objective To explore the value of amide proton transfer weight (APTw) imaging in the differential diagnosis of prostatitis, prostatic hyperplasia (BPH) and prostate cancer (PCa).Materials and Methods A retrospective analysis was made on 133 patients with prostate diseases who underwent 3.0 T MRI scanning and were confirmed by pathology, including 41 cases of BPH, 23 cases of prostatitis and 69 cases of PCa. APTw values of all lesions were measured by two observers. Intra-class correlation coefficient (ICC) was used to test the consistency of APTw values measured by two observers. The age and prostate specific antigen [including total prostate specific antigen (tPSA) and free prostate specific antigen (fPSA)] of all patients were recorded. Multivariate logistic regression was used to screen possible independent risk factors of PCa. Firstly, the differences of parameters between benign and malignant groups were compared, and then the comparisons among PCa, BPH and prostatitis were made. T-test was used to compare the differences between benign and malignant lesions, and one-way analysis of variance (ANOVA) was used to compare the differences of quantitative parameters among the three groups. The measurement data conforming to the skewed distribution are expressed by the median (interquartile interval), and the differences between different groups are compared by Mann-Whitney rank sum test. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy of different parameters in different groups. DeLong test was used to compare the diagnostic efficiency of each parameter and joint parameters.Results The APTw values measured by the two observers are in good agreement (ICC > 0.75). Multivariate logistic regression analysis showed that age and tPSA were possible independent risk factors for screening PCa (P < 0.05). Compared with benign prostate diseases (prostatitis and BPH), the age, tPSA and APTw values of PCa group were all higher than those of benign prostate diseases group, the differences were statistically significant (P < 0.05). Compared with PCa, BPH and prostatitis, PCa group was older than BPH group, and the difference was statistically significant (P < 0.05), but there was no statistical difference among other groups. tPSA in PCa group was higher than that in prostatitis group and BPH group, and the differences were statistically significant (P < 0.05), there was no significant difference in tPSA between prostatitis group and BPH group (P > 0.05). The APTw value in PCa group was higher than that in prostatitis group and BPH group, and the difference was statistically significant (P < 0.05), but there was no statistical difference between prostatitis group and BPH group (P > 0.05). The clinical indicators (age, tPSA), APTw value and the area under ROC curve (AUC) of APTw combined with clinical indicators in differentiating benign and malignant prostate lesions were 0.754, 0.755 and 0.838, respectively, and the diagnostic efficiency of clinical indicators and APTw value combined with clinical indicators was statistically significant (P < 0.05). The AUC of tPSA, APTw and APTw combined with tPSA in differentiating PCa from prostatitis were 0.680, 0.739 and 0.783, respectively, and there was no significant difference in diagnostic efficiency (P > 0.05).Conclusions APT value has a good clinical application prospect in differentiating benign and malignant prostate diseases. Combined with clinical indicators, it can improve the diagnostic efficiency, and can well distinguish PCa from prostatitis and BPH. In addition, APTw value combined with tPSA value can improve the diagnosis of PCa and prostatitis to a certain extent, providing new ideas for clinical diagnosis and subsequent treatment methods.
[Keywords] amide proton transfer weight；prostate cancer；benign prostatic hyperplasia；prostatitis；magnetic resonance imaging

CHEN Lihua1, 2   WANG Siqi1   ZHANG Yumeng1   SONG Qingwei1, 2, 3   LIN Liangjie4   WANG Jiazheng3   ZHANG Qinhe1, 2, 3   LIU Ailian1, 2, 3*  

1 Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

2 Dalian Medical Imaging Artificial Intelligence Technology Innovation Center, Dalian 116011, China

3 Liaoning Super Magnetic Resonance Professional Technology Innovation Center, Dalian 116011, China

4 Philips (China) Investment Co., Ltd. Beijing Branch, Beijing 100600, China

Corresponding author: LIU A L, E-mail: liuailian@dmu.edu.cn

Conflicts of interest   None.

Received  2026-03-10
Accepted  2026-07-10
DOI: 10.12015/issn.1674-8034.2026.08.010
Cite this article as CHEN L H, WANG S Q, ZHANG Y M, et al. The value of APTw imaging in the differential diagnosis of prostatic diseases[J]. Chin J Magn Reson Imaging, 2026, 17(8): 98-106. DOI:10.12015/issn.1674-8034.2026.08.010.

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