Diagnosis value of monoexponential and biexponential diffusion-weighted imaging for central gland prostate cancer and prostatic hyperplasia

Abstract

Objective To compare the diagnosis values of the standard apparent diffusion coefficient(ADCtotal)that calculated from the monoexponential diffusion-weighted imaging(DWI)and the parameters(slow apparent diffusion coefficient[ADCslow],fast apparent diffusion coefficient[ADCfast]and fraction of ADC [f])derived from the biexponential DWI for central gland(CG)prostate cancer,glandular prostatic hyperplasia(GH)and stromal prostatic hyperplasia(SH).Methods The clinical data of 23 patients with CG prostate cancer,19 patients with GH and 24 patients with SH,who were proven by magnetic resonance/transrectal ultrasound(MR/TRUS)fusion-guided target biopsy were retrospectively analyzed.All the patients underwent MRI examination including T2 WI,T1WI and b-value DWI before biopsy.The b-values of DWI were 0,50,100,150,200,500,800,1 000,1 500 and 2 000s/mm2.The match of target biopsy area and DWI images was done based on the pathology results.Then the ADCtotal,ADCslow,ADCfastand f values were measured for all the pathological types.KruskalWallis test was used for difference comparison,and receiver operating characteristic(ROC)analysis was performed to analyze each parameter and evaluate their diagnostic efficiency for CG prostate cancer,SH and GH.Results The ADCtotal(×10-3mm2/s)values of CG prostate cancer,GH and SH were(0.46±0.06),(0.87±0.19)and(0.68±0.09);the ADCslow(×10-3mm2/s)values were(0.39±0.13),(0.57±0.15)and(0.49±0.13);the ADCfast(×10-3 mm2/s)values were(4.8±2.5),(3.6±0.76)and(4.5±1.8);and the f values were(0.43±0.10),(0.68±0.09)and(0.58±0.08),respectively.There were significant differences in ADCtotal,ADCslowand f values among different groups(P=0.000,0.001 and 0.000),but not in ADCfastvalues(P=0.489).The area under curve(AUC)of ADCtotal,ADCslowand f value for CG prostate cancer and GH were1,0.828,and 0.971,respectively.The AUC values of ADCtotal,ADCslowand f value for differential diagnosis of CG prostate cancer and SH were 0.991,0.719,and 0.861,respectively.The AUC values of ADCtotal,ADCslowand f value for GH and SH were 0.876,0.650,and 0.831,respectively.Conclusion When b value is 0-2 000s/mm2,the ADCtotalthat calculated from the monoexponential model for diagnosis of CG prostate cancer,GH and SH is more efficient than the ADCslow and f value that derived from biexponential model.