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Diagnosis and risk stratification of PI-RADS v2.1 category 3-5 lesions using amide proton transfer imaging

  • 0Department of Radiology, The First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Hefei, Anhui Province, 230032, China.
World Journal of Urology +

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May 6, 2025

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May 6, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

Amide proton transfer-weighted imaging (APTWI), apparent diffusion coefficient (ADC), and prostate-specific antigen density (PSAD) effectively evaluate prostate cancer risk. Combining these methods offers the highest diagnostic accuracy for aggressive lesions.

Area Of Science

  • Radiology and Medical Imaging
  • Oncology
  • Biomarkers

Background

  • Prostate cancer risk stratification is crucial for appropriate treatment.
  • Accurate differentiation between benign and malignant prostate lesions is challenging.
  • PI-RADS v2.1 category 3-5 lesions require further evaluation for aggressive disease.

Purpose Of The Study

  • To assess the diagnostic value of amide proton transfer-weighted imaging (APTWI) in combination with apparent diffusion coefficient (ADC) and prostate-specific antigen density (PSAD).
  • To evaluate the risk of aggressive prostate cancer (PCa) in PI-RADS v2.1 category 3-5 lesions.
  • To compare the efficacy of individual and combined parameters for PCa detection and risk stratification.

Main Methods

  • Retrospective analysis of 69 PCa patients and 32 benign lesion patients.
  • Comparison of APTWI parameters, ADC, and PSAD between PCa and benign lesion groups.
  • Utilized receiver operating characteristic (ROC) and precision recall (PR) curves for diagnostic accuracy assessment.

Main Results

  • APTWI parameters and PSAD were significantly higher in PCa than benign lesions; ADC was lower.
  • ADC demonstrated the highest diagnostic accuracy, followed by PSAD and APT<sub>min</sub>.
  • The combination of APT<sub>min</sub>+ADC+PSAD achieved the highest AUC (0.997) for PCa diagnosis. APT<sub>mean</sub> combined with ADC and PSAD showed high efficacy (0.956) for aggressive PCa risk evaluation.

Conclusions

  • APTWI serves as a valuable biomarker for prostate cancer risk stratification in PI-RADS v2.1 category 3-5 lesions.
  • Combining APTWI with PSAD and ADC significantly enhances diagnostic efficacy.
  • This multi-parametric approach improves the identification and risk assessment of aggressive prostate cancer.

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