Histogram analysis of stretched-exponential and monoexponential diffusion-weighted imaging models for distinguishing low and intermediate/high gleason scores in prostate carcinoma.

Abstract

Noninvasive measures to evaluate the aggressiveness of prostate carcinoma (PCa) may benefit patients. To assess the value of stretched-exponential and monoexponential diffusion-weighted imaging (DWI) for predicting the aggressiveness of PCa. Retrospective study. Seventy-five patients with PCa. 3T DWI examinations were performed using b-values of 0, 500, 1000, and 2000 s/mm2 . The research were based on entire-tumor histogram analysis and the reference standard was radical prostectomy. The correlation analysis was programmed with Spearman's rank-order analysis between the histogram variables and Gleason grade group (GG). Receiver operating characteristic (ROC) regression was used to analyze the ability of these histogram variables to differentiate low-grade (LG) from intermediate/high-grade (HG) PCa. The percentiles and mean of apparent diffusion coefficient (ADC) and distributed diffusion coefficient (DDC) were correlated with GG (ρ: 0.414-0.593), while there was no significant relation among α value, skewnesses, and kurtosises with GG (ρ:0.034-0.323). HG tumors (ADC:484 ± 136, 592 ± 139, 670 ± 144, 788 ± 146, 895 ± 141 mm2 /s; DDC: 410 ± 142, 532 ± 172, 666 ± 193, 786 ± 196, 914 ± 181 mm2 /s) had lower values in the 10th , 25th , 50th , 75th percentiles and means than LG tumors (ADC: 644 ± 779, 737 ± 84, 836 ± 83, 919 ± 82, 997 ± 107 mm2 /s; DDC: 552 ± 82, 680 ± 94, 829 ± 112, 931 ± 106, 1045 ± 100 mm2 /s). However, there was no difference between LG and HG tumors in α value (0.671 ± 0.041 vs. 0.633 ± 0.114), kurtosises (ADC 0.09 vs. 0.086; DDC -0.033 vs. -0.317), or skewnesses (ADC -0.036 vs. 0.073; DDC -0.063 vs. 0.136). The above statistics were P < 0.01. ADC10 with AUC = 0.840 and DDC10 with AUC = 0.799 were similar in discriminating between LG and HG PCa at P < 0.05. Histogram variables of DDC and ADC may predict the aggressiveness of PCa, while α value does not. The abilities of ADC10 and DDC10 to discriminate LG from HG tumors were similar, and both better than their respective means. 3 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2018;48:491-498.