Abstract
Prostate cancer (PCa) is the second most common cancer in men worldwide and the most frequently diagnosed cancer among men in more developed countries. The prognosis of PCa is excellent if detected at an early stage, making early screening crucial for detection and treatment. In recent years, a new form of diffusion magnetic resonance imaging called correlated diffusion imaging (CDI) was introduced, and preliminary results show promise as a screening tool for PCa. In the largest study of its kind, we investigate the relationship between PCa presence and a new variant of CDI we term synthetic correlated diffusion imaging (CDI^s), as well as its performance for PCa delineation compared to current standard MRI techniques [T2-weighted (T2w) imaging, diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) imaging] across a cohort of 200 patient cases. Statistical analyses reveal that hyperintensity in CDI^s is a strong indicator of PCa presence and achieves strong delineation of clinically significant cancerous tissue compared to T2w, DWI, and DCE. These results suggest that CDI^s hyperintensity may be a powerful biomarker for the presence of PCa, and may have a clinical impact as a diagnostic aid for improving PCa screening.
Highlights
Prostate cancer (PCa) is the second most common cancer in men worldwide and the most frequently diagnosed cancer among men in more developed countries
Consistent with the contemporary concept of clinically significant PCa (csPCa) versus insPCa21, csPCa tissue is defined as tissue with a Gleason score greater than or equal to 7 (Gleason Grade Groups 2-5 according to the International Society of Urological Pathology) while insignificant PCa (insPCa) tissue is defined as tissue with a Gleason score less than 7 (Gleason Grade Group 1)
The T2w SI distributions of healthy tissue, csPCa tissue, and insPCa tissue all have considerable overlap, while the value distributions of insPCa tissue and csPCa tissue have greater overlap for both Ktrans and apparent diffusion coefficient (ADC) values. This observation means that correlated diffusion imaging (CDI) can potentially be a good clinical decision support tool for clinicians when compared to the current standard Magnetic resonance imaging (MRI) techniques in determining the course of action for a patient, be it watchful waiting, active surveillance, or immediate treatment
Summary
Prostate cancer (PCa) is the second most common cancer in men worldwide and the most frequently diagnosed cancer among men in more developed countries. Statistical analyses reveal that hyperintensity in CDIs is a strong indicator of PCa presence and achieves strong delineation of clinically significant cancerous tissue compared to T2w, DWI, and DCE These results suggest that CDIs hyperintensity may be a powerful biomarker for the presence of PCa, and may have a clinical impact as a diagnostic aid for improving PCa screening. To improve diagnostic accuracy when using MRI for PCa screening and diagnosis, two complementary MRI techniques have been leveraged for improved PCa screening alongside T2w: (1) diffusion-weighted imaging (DWI) with apparent diffusion coefficient (ADC) calculated from DWI, and (2) dynamic contrast-enhanced (DCE) imaging[17]. These techniques, Scientific Reports | (2022) 12:3376. The need to interpret several modalities can increase interpretation challenges, resulting in increased inter- and intra-observer variability
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