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Detection of prostate cancer in peripheral zone: comparison of MR diffusion tensor imaging, quantitative dynamic
Chunmei Li1, Min Chen, Saying Li
1Department of Radiology, Beijing Hospital of the Ministry of Health, Beijing, China.
Background:
Previous studies have shown that the diagnostic accuracy for prostate cancer improved with diffusion tensor imaging (DTI) or quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) only. However, the efficacy of combined DTI and quantitative DCE-MRI in detecting prostate cancer at 3.0 T is still indeterminate.
Purpose:
To investigate the utility of diffusion tensor imaging (DTI), quantitative DCE-MRI, and the two techniques combined at 3.0 T in detecting prostate cancer of the peripheral zone (PZ).
Material And Methods:
DTI and DCE-MRI of 33 patients was acquired prior to prostate biopsy. Regions of interest (ROIs) were drawn according to biopsy zones which were apex, mid-gland, and base on each side of the PZ. Apparent diffusion coefficient (ADC), fractional anisotropy (FA), volume transfer constant (K(trans)), and rate constant (kep) values of cancerous sextants and non-cancerous sextants in PZ were calculated. Logistic regression models were generated for DTI, DCE-MRI, and DTI + DCE-MRI. Receiver-operating characteristic (ROC) curves were used to compare the ability of these models to differentiate cancerous sextants from non-cancerous sextants of PZ.
Results:
There were significant differences in the ADC, FA, K(trans), and kep values between cancerous sextants and non-cancerous sextants in PZ (P < 0.0001, P < 0.0001, P < 0.0001, and P < 0.0001, respectively). The area under curve (AUC) for DTI + DCE-MRI was significantly greater than that for either DTI (0.93 vs. 0.86, P = 0.0017) or DCE-MRI (0.93 vs. 0.84, P = 0.0034) alone.
Conclusion:
The combination of DTI and quantitative DCE-MRI has better diagnostic performance in detecting prostate cancer of the PZ than either technique alone.
Insights
Combining diffusion tensor imaging (DTI) and quantitative dynamic contrast-enhanced MRI (DCE-MRI) significantly improves prostate cancer detection in the peripheral zone. This combined approach offers superior diagnostic performance compared to using either DTI or DCE-MRI alone.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Previous research indicates diffusion tensor imaging (DTI) and quantitative dynamic contrast-enhanced MRI (DCE-MRI) individually enhance prostate cancer diagnostic accuracy.
- However, the combined efficacy of DTI and quantitative DCE-MRI at 3.0 Tesla (T) for prostate cancer detection remains unclear.
Purpose of the Study:
- To evaluate the diagnostic utility of DTI, quantitative DCE-MRI, and their combination at 3.0 T for detecting prostate cancer in the peripheral zone (PZ).
Main Methods:
- DTI and DCE-MRI were performed on 33 patients before prostate biopsy.
- Regions of interest were defined across the PZ (apex, mid-gland, base).
- Apparent diffusion coefficient (ADC), fractional anisotropy (FA), K(trans), and kep values were calculated for cancerous and non-cancerous sextants, with logistic regression and ROC curve analysis used for comparison.
Main Results:
- Significant differences in ADC, FA, K(trans), and kep were observed between cancerous and non-cancerous PZ sextants (P < 0.0001 for all).
- The combined DTI + DCE-MRI approach yielded a significantly higher area under the curve (AUC) of 0.93 compared to DTI alone (0.86, P=0.0017) and DCE-MRI alone (0.84, P=0.0034).
Conclusions:
- The combination of DTI and quantitative DCE-MRI demonstrates superior diagnostic performance for detecting prostate cancer in the peripheral zone compared to either technique used independently.
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