Abstract
BackgroundTo explore the usefulness of analyzing histograms and textures of apparent diffusion coefficient (ADC) maps and T2-weighted (T2W) images to differentiate prostatic cancer (PCa) from benign prostatic hyperplasia (BPH) using histopathology as the reference.MethodsNinety patients with PCa and 112 patients with BPH were included in this retrospective study. Differences in whole-lesion histograms and texture parameters of ADC maps and T2W images between PCa and BPH patients were evaluated using the independent samples t-test. The diagnostic performance of ADC maps and T2W images in being able to differentiate PCa from BPH was assessed using receiver operating characteristic (ROC) curves.Results The mean, median, 5th, and 95th percentiles of ADC values in images from PCa patients were significantly lower than those from BPH patients (p < 0.05). Significant differences were observed in the means, standard deviations, medians, kurtosis, skewness, and 5th percentile values of T2W image between PCa and BPH patients (p < 0.05). The ADC5th showed the largest AUC (0.906) with a sensitivity of 83.3 % and specificity of 89.3 %. The diagnostic performance of the T2W image histogram and texture analysis was moderate and had the largest AUC of 0.634 for T2WKurtosis with a sensitivity and specificity of 48.9% and 79.5 %, respectively. The diagnostic performance of the combined ADC5th & T2WKurtosis parameters was also similar to that of the ADC5th & ADCDiff−Variance.ConclusionsHistogram and texture parameters derived from the ADC maps and T2W images for entire prostatic lesions could be used as imaging biomarkers to differentiate PCa and BPH biologic characteristics, however, histogram parameters outperformed texture parameters in the diagnostic performance.
Highlights
To explore the usefulness of analyzing histograms and textures of apparent diffusion coefficient (ADC) maps and T2-weighted (T2W) images to differentiate prostatic cancer (PCa) from benign prostatic hyperplasia (BPH) using histopathology as the reference
Kuhl et al found that bi-parametric Magnetic resonance imaging (MRI) and multi-parametric magnetic resonance imaging (mpMRI) (T2WI, Diffusionweighted imaging (DWI), and dynamic contrast-enhanced MRI) had similar diagnostic efficiency and accuracy. bpMRI image interpretations were have a good consistency among radiologists, and the diagnostic accuracy of tumor detection was similar to that of mpMRI
The results demonstrated that histogram and texture analyses of parameters from ADC and T2W images could be useful to differentiate PCa from BPH, histogram parameters outperformed texture parameters in the diagnostic performance
Summary
To explore the usefulness of analyzing histograms and textures of apparent diffusion coefficient (ADC) maps and T2-weighted (T2W) images to differentiate prostatic cancer (PCa) from benign prostatic hyperplasia (BPH) using histopathology as the reference. Increased serum prostate-specific antigen (PSA) levels and abnormal digital rectal examinations have been used as detection methods. These tests have resulted in the insufficient detection of high-grade PCa tumors and excessive detection of low-grade lesions [2]. Dynamic contrast-enhanced (DCE) MRI characterizes the pharmacokinetic tissue properties through imaging during the administration of contrast agent This method has several limitations, such as potential adverse reactions to gadolinium administration, additional scanning time and cost, and poor consistency in the interpretation of images among radiologists, limiting its broad application in clinical practice [10, 11]
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