Multiparametric Magnetic Resonance Imaging With Comprehensive Assessment of Prostate Volume, Morphology, and Composition Better Reflects the Correlation With International Prostate Symptom Score

Abstract

To investigate the application of multiparametric MRI (mp-MRI) for comprehensive evaluation of the correlation between the characteristics of the transitional zone and the International Prostate Symptom Score (IPSS) in patients with benign prostatic hyperplasia (BPH). We retrospectively recruited 210 patients with biopsy-proven BPH who underwent preoperative mp-MRI and were assigned an IPSS. The evaluation indicators included prostate volumetric parameters [total prostate volume (TPV), transition zone volume (TZV), and transition zone index (TZI, TZI=TZV/TPV)], prostate morphological parameters [intravesical prostatic protrusion (IPP), and presumed circle area ratio (PCAR)] and prostate compositional parameters [apparent diffusion coefficient (ADC), and mean signal intensity of T2WI (mean-SI-T2WI)]. The Pearson (r) correlation coefficient, one-way analysis of variance (ANOVA) and multiple linear regression analysis were used to build a regression model for evaluating the correlation between MRI-derived parameters and IPSS, IPSS-storage symptom (IPSS-ss), IPSS-voiding symptom (IPSS-vs). Significant correlations were found between IPSS, IPSS-ss, IPSS-vs and prostate MRI-derived parameters, including TPV (r=0.350; r=0.466; r=0.225, P<0.001), TZV (r=0.374; r=0.492; r=0.243, P<0.001), TZI (r=0.383; r=0.313; r=0.354, P<0.001), PCAR (r=0.481; r=0.356; r=0.469, P<0.001), ADC(r=-0.198; r=-0.053; r=-0.239, P<0.05) and mean-SI-T2WI (r=-0.626; r=-0.310; r=-0.687, P<0.001) respectively. Based on multiple linear regression analysis, the impact of mean-SI-T2WI and TZI on total IPSS were statistically significant (P<0.05), and the regression equation established with the analysis [IPSS=39.224+8.469×TZI+(-0.09)×(mean-SI-T2WI)] was statistically significant (F=104.995, P<0.001). Mp-MRI could be used to evaluate the volume and morphology of BPH. In particular, mean-SI-T2WI and ADC could be used to describe the internal composition of the prostate. The imaging parameters were effective for evaluating BPH.