Abstract
Objective: This study aimed to compare the potential of monoexponential model (MEM), intravoxel incoherent motion (IVIM) model, kurtosis model, and IVIM–kurtosis model in the diagnosis and aggressiveness assessment of prostate cancer (PCa).Materials and Methods: Thirty-six patients were recruited. Diffusion-weighted images were acquired on a 3.0-T magnetic resonance imaging (MRI) system using 0 b values up to 2,000 s/mm2 and analyzed using four models: MEM (ADCMEM), IVIM (DIVIM, D*IVIM, f IVIM), kurtosis (Dkurtosis, Kkurtosis), and IVIM–kurtosis (DIVIM−kurtosis, D*IVIM−kurtosis, fIVIM−kurtosis, DIVIM−kurtosis) models. The values of these parameters were calculated and compared between PCa, benign prostatic hyperplasia (BPH), and prostatitis. Correlations between these parameters and the Gleason score (GS) of PCa were evaluated using the Pearson test.Results: Forty-five lesions were studied, including 18 PCa, 12 prostatitis, and 15 BPH lesions. The ADCMEM, DIVIM, fIVIM, Dkurtosis, and DIVIM−kurtosis values were significantly lower and Kkurtosis and KIVIM−kurtosis values were significantly higher in PCa compared with prostatitis and BPH. The area under the curve (AUC) of ADCMEM showed significantly higher values than that of fIVIM and KIVIM−kurtosis, but no statistical differences were found between the other parameters. The D*IVIM−kurtosis value correlated negatively and fIVIM−kurtosis and KIVIM−kurtosis values correlated positively with the GS.Conclusion: The MEM, IVIM, kurtosis, and IVIM–kurtosis models were all useful for the diagnosis of PCa, and the diagnostic efficacy seemed to be similar. The IVIM–kurtosis model may be superior to the MEM, IVIM, and kurtosis models in the grading of PCa.
Highlights
Prostate cancer (PCa) is the second-most frequent cancer and the fifth leading cause of cancer-related mortality in men worldwide [1]
The Akaike Information Criteria (AIC) of intravoxel incoherent motion (IVIM) and IVIM-kurtosis were lower than the AIC of Kurtosis, but no differences were found between the AIC of IVIM and IVIM-kurtosis
The Kkurtosis and KIVIM−kurtosis values were significantly higher in PCa compared with prostatitis and BPH, but no differences were found between prostatitis and BPH
Summary
Prostate cancer (PCa) is the second-most frequent cancer and the fifth leading cause of cancer-related mortality in men worldwide [1]. Among various MRI techniques available, diffusion-weighted imaging (DWI) shows great potential to be applied as a clinical marker of tumor diagnosis and aggressiveness assessment [3,4,5]. Overlaps exist between quantitative ADC values derived from PCa with a higher and a lower GS, as well as between those derived from benign prostatic tissues [8]. This may be due to a drawback of the MEM, which assumes a Gaussian distribution of the water thermal motion. Non-Gaussian diffusion models have been introduced for the study of DWI, such as intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI). The results of IVIM and DKI for assessing the aggressiveness of PCa were various; several studies showed that IVIM [16,17,18] and DKI [22,23,24] were feasible to stratify the pathological grade of PCa, but a few studies found negative results of IVIM [15] and DKI [20] parameters in predicting the GS
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
