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Published on: September 25, 2019
The evaluation of prostate lesions with IVIM DWI and MR perfusion parameters at 3T MRI
Murat Beyhan1, Recep Sade2, Erdem Koc3
1Radiology Clinic, Tokat State Hospital, Tokat, Turkey.
Purpose:
The purpose of our study was to analyze the difference between IVIM DWI and perfusion parameters of malignant lesions and benign lesions-normal prostate tissue.
Methods:
This prospective study included 31 patients who had multiparametric prostate MRI with IVIM DWI due to elevated prostate-specific antigen level and clinical suspicion between February 2015 and September 2016.
Results:
For peripheral zone, the mean values of Ktrans, Kep, iAUC, χ2 and f were significantly higher in malignant lesions, and the mean values of Dt were significantly lower in malignant lesions (p 0.00, p 0.02, p 0.00, p 0.02 and p 0.00, respectively). For transitional zone, the mean values of Ktrans, Ve, iAUC, χ2 and f were significantly higher in malignant lesions, and the mean values of Dp and Dt were significantly lower in malignant lesions (p 0.00, p 0.00, p 0.00, p 0.00, p 0.00, p 0.02 and p 0.00, respectively). For whole prostate gland, the mean values of Ktrans, Kep, Ve, iAUC, χ2 and f were significantly higher in malignant lesions, and the mean values of Dp and Dt were significantly lower in malignant lesions (p 0.00, p 0.03, p 0.00, p 0.00, p 0.00, p 0.01, p 0.04 and p 0.00, respectively).
Conclusions:
Restricted diffusion-pseudodiffusion and increased perfusion parameters are important to differentiate prostate cancer from benign pathologies. It is also important to keep in mind that transitional zone and peripheral zone tumors may have different perfusion and diffusion parameters. Future studies are needed to confirm our findings.
Insights
Diffusion and perfusion MRI parameters can help differentiate prostate cancer from benign conditions. Malignant lesions show restricted diffusion and increased perfusion, but parameters vary between prostate zones.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Prostate cancer diagnosis often relies on PSA levels and clinical suspicion.
- Multiparametric MRI, including IVIM DWI, offers advanced imaging capabilities.
Purpose of the Study:
- To compare Intravoxel Incoherent Motion Diffusion-Weighted Imaging (IVIM DWI) and perfusion parameters between malignant and benign prostate lesions.
- To assess the utility of these parameters in differentiating prostate cancer from normal prostate tissue.
Main Methods:
- Prospective study of 31 patients with elevated PSA and clinical suspicion.
- Utilized multiparametric MRI with IVIM DWI.
- Analyzed diffusion (D, Dp, Dt) and perfusion (Ktrans, Kep, Ve, iAUC, χ², f) parameters.
Main Results:
- Malignant lesions exhibited significantly higher Ktrans, Kep, Ve, iAUC, χ², and f values compared to benign tissue.
- Malignant lesions showed significantly lower Dp and Dt values across the peripheral zone, transitional zone, and whole prostate gland.
- Statistical significance (p < 0.05) was observed for most parameter differences.
Conclusions:
- Restricted diffusion and enhanced perfusion parameters are key indicators for differentiating prostate cancer.
- Perfusion and diffusion characteristics may differ between tumors in the transitional and peripheral zones of the prostate.
- Further research is recommended to validate these findings.
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