Cancer Management and Research (Jul 2021)
The Assessment of Prostate Cancer Aggressiveness Using a Combination of Quantitative Diffusion-Weighted Imaging and Dynamic Contrast-Enhanced Magnetic Resonance Imaging
Abstract
Guangbin Zhu,1,* Jinwen Luo,1,* Zhongmin Ouyang,1 Zenglan Cheng,1 Yi Deng,1 Yubao Guan,1 Guoxin Du,1 Fengjin Zhao2 1Guangzhou Key Laboratory of Enhanced Recovery after Abdominal Surgery, Department of Radiology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510799, People’s Republic of China; 2Department of Urology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510799, People’s Republic of China*These authors contributed equally to this workCorrespondence: Zhongmin OuyangGuangzhou Key Laboratory of Enhanced Recovery after Abdominal Surgery, Department of Radiology, The Fifth Affiliated Hospital of Guangzhou Medical University, No. 621 of Gangwan Road, Huangpu District, Guangzhou, 510799, People’s Republic of ChinaTel +86-20-85959142Email [email protected]: To explore the value of combining dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) quantitative parameters with apparent diffusion coefficient (ADC) values in the diagnosis of prostate cancer.Methods: The clinical data of 146 patients with prostate lesions, including 87 patients with prostate cancer (PCa) and 59 with benign prostatic hyperplasia (BPH), were collected. After DCE-MRI and diffusion-weighted imaging (DWI) prostate scans, the magnitude of the DCE-MRI transfer constant (Ktrans), rate constant (kep), the volume of the extravascular extracellular space (ve), and the ADC between the groups were compared, and the correlations between the DCE-MRI parameters and Gleason scores were analyzed. The diagnostic efficacy of these quantitative parameters was assessed by the area under the receiver operating characteristic (ROC) curve.Results: The DCE-MRI parameters Ktrans and kep were significantly greater in the PCa group than in the BPH group (p < 0.05). The ROC curve showed the area under the Ktrans, kep, and ADC curves to be 0.665, 0.658, and 0.782, respectively. When all three quantitative indicators were combined, the area under the ROC curve was 0.904, with sensitivity and specificity rates of 83.6% and 93.7%, respectively. The Gleason scores were positively correlated with the Ktrans, kep, and ve (r = 0.39, 0.572, 0.30, respectively; p < 0.05) and negatively correlated with the ADC (r = – 0.525; p < 0.05).Conclusion: The DCE-MRI quantitative parameters Ktrans and kep, as well as the ADC value, provided effective references for the differential diagnosis of PCa and BPH, as well as more precise and reliable quantitative parameters for grading the aggressiveness of PCa.Keywords: quantitative DWI, dynamic contrast-enhanced MRI, ADC value, Ktrans, kep, benign prostatic hyperplasia, prostate cancer
