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Magnetic resonance imaging in prostate cancer: the value of apparent diffusion coefficients for identifying malignant nodules

2007; Wiley; Volume: 80; Issue: 950 Linguagem: Inglês

10.1259/bjr/24232319

1748-880X

N M deSouza, Stefan A. Reinsberg, Erica Scurr, Jonathan M. Brewster, Geoffrey S. Payne,

Radiomics and Machine Learning in Medical Imaging

The aim of this work was to determine the potential of diffusion weighted magnetic resonance imaging (DW-MRI) for identifying prostate cancer by comparing apparent diffusion coefficients (ADCs) from malignant peripheral zone (PZ) nodules with values from the non-malignant PZ and the predominantly benign central gland (CG). 33 patients with elevated prostate specific antigen (PSA) aged 52–78 years (30 patients with biopsy proven prostate cancer) underwent endorectal MRI with T2 weighted and echo planar diffusion weighting (b = 0 mm2 s−1, 300 mm2 s−1, 500 mm2 s−1 and 800 mm2 s−1) sequences. ADCs were measured from 30 malignant PZ nodules (identified on T2 weighting and positive biopsy; median region of interest (ROI) size 41 mm2), 33 CG regions (predominantly benign nodules; median ROI size 218 mm2) and 18 non-malignant PZ regions (ipsilateral biopsies all benign; median ROI size 54.5 mm2). ADCs were (mean±standard deviation (SD); mm2 s−1): malignant PZ nodules 1.30±0.30×10−3, CG 1.46±0.14×10−3 and non-malignant PZ 1.71±0.16×10−3. Differences between all three groups were statistically significant (p = 0.01 malignant PZ vs CG; p = 0.0001 malignant PZ vs non-malignant PZ and p = 0.0001 CG vs non-malignant PZ). Using receiver operating characteristic curves, cut-off values of 1.39×10−3 mm2 s−1 differentiated malignant PZ nodules from predominantly benign CG (sensitivity 60%, specificity 76%) and of 1.6×10−3 mm2 s−1 identified malignant from non-malignant PZ (sensitivity 86.7%, specificity 72.2%). These results suggest that DW-MRI has the potential to increase the specificity of prostate cancer detection because ADCs are significantly lower in malignant compared with non-malignant prostate tissue.