Comparison of Diffusion Kurtosis Imaging and Amide Proton Transfer Imaging in the Diagnosis and Risk Assessment of Prostate Cancer.

Huijia Yin,Ruifang Yan,Kaiyu Wang,Dongdong Wang,Zhansheng Zhai,Xingxing Jin,Dongming Han,Jinhui Duan,Ying Hu,Jian Zhang

doi:10.3389/fonc.2021.640906

Abstract

ObjectivesThis study aims to evaluate and compare the diagnostic value of DKI and APT in prostate cancer (PCa), and their correlation with Gleason Score (GS).Materials and MethodsDKI and APT imaging of 49 patients with PCa and 51 patients with benign prostatic hyperplasia (BPH) were collected and analyzed, respectively. According to the GS, the patients with PCa were divided into high-risk, intermediate-risk and low-risk groups. The mean kurtosis (MK), mean diffusion (MD) and magnetization transfer ratio asymmetry (MTRasym, 3.5 ppm) values among PCa, BPH, and different GS groups of PCa were compared and analyzed respectively. The diagnostic accuracy of each parameter was evaluated by using the receiver operating characteristic (ROC) curve. The correlation between each parameter and GS was analyzed by using Spearman’s rank correlation.ResultsThe MK and MTRasym (3.5 ppm) values were significantly higher in PCa group than in BPH group, while the MD value was significantly lower than in BPH group. The differences of MK/MD/MTRasym (3.5 ppm) between any two of the low-risk, intermediate-risk, and high-risk groups were all statistically significant (p <0.05). The MK value showed the highest diagnostic accuracy in differentiating PCa and BPH, BPH and low-risk, low-risk and intermediate-risk, intermediate-risk and high-risk (AUC = 0.965, 0.882, 0.839, 0.836). The MK/MD/MTRasym (3.ppm) values showed good and moderate correlation with GS (r = 0.844, −0.811, 0.640, p <0.05), respectively.ConclusionDKI and APT imaging are valuable in the diagnosis of PCa and demonstrate strong correlation with GS, which has great significance in the risk assessment of PCa.

Highlights

Prostate cancer (PCa) is the second most common cancer in men and the second leading cause of cancer death [1], with its incidence continuing to rise [2]
The Gleason scoring (GS) system is the golden standard for the diagnosis of PCa [4] with a form of the main structural type + secondary structural type according to the degree of differentiation of the glands in the tumor and its growth in the interstitial
The images of derived parameters of Diffusion kurtosis imaging (DKI) and Amide proton transfer weighted imaging (APTWI) are shown in Figures 2 and 3

Summary

Introduction

Prostate cancer (PCa) is the second most common cancer in men and the second leading cause of cancer death [1], with its incidence continuing to rise [2]. Most patients are already in advanced stage of PCa at the time of treatment [2]. Early accurate diagnosis and evaluation of the aggressiveness of PCa is of great significance [3]. The Gleason scoring (GS) system is the golden standard for the diagnosis of PCa [4] with a form of the main structural type + secondary structural type according to the degree of differentiation of the glands in the tumor and its growth in the interstitial. GS is an important index to reflect the risk and biological aggressiveness of PCa [4, 5]. The treatment strategies and prognosis of PCa vary according to different GSs [6]. For male patients with clinically suspected PCa, it is necessary to find a non-invasive method to accurately diagnose and evaluate its risk and aggressiveness

Objectives

Methods

Results

Discussion

Conclusion