Differentiation of prostate cancer lesions with high and with low Gleason score by diffusion-weighted MRI.

Objectives: To differentiate prostate cancer lesions with high and with low Gleason score by diffusion-weighted-MRI (DW-MRI).Methods: This prospective study was approved by the responsible ethics committee. DW-MRI of 84 consenting prostate and/or bladder cancer patients scheduled for radical prostat...

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Publicado en:European Radiology Vol. 27; no. 4; pp. 1547 - 1556
Autores principales: Barbieri, Sebastiano, Brönnimann, Michael, Boxler, Silvan, Vermathen, Peter, Thoeny, Harriet, Thoeny, Harriet C
Formato: diagnostic images research tables/charts Journal Article
Publicado: Springer Nature Apr2017
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Differentiation of prostate cancer lesions with high and with low Gleason score by diffusion-weighted MRI.
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          Barbieri, Sebastiano
          Brönnimann, Michael
          Boxler, Silvan
          Vermathen, Peter
          Thoeny, Harriet
          Thoeny, Harriet C
        affil: Institute of Diagnostic, Pediatric, and Interventional Radiology , Inselspital University Hospital , Inselspital, Freiburgstrasse 10 CH-3010 Bern Switzerland
      sug:
        subj:
          Magnetic Resonance Imaging Methods
          Prostatic Neoplasms Pathology
          Prostatic Neoplasms
          Prostate Pathology
          Prostatectomy
          Prostate
          Image Interpretation, Computer Assisted Methods
          Prostatic Neoplasms Surgery
          Neoplasm Grading
          Prospective Studies
          Adult
          Male
          Aged
          Diagnosis, Differential
          Middle Age
          Aged, 80 and Over
          Human
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
          Aged, 80 & over
          Male
      ab: Objectives: To differentiate prostate cancer lesions with high and with low Gleason score by diffusion-weighted-MRI (DW-MRI).Methods: This prospective study was approved by the responsible ethics committee. DW-MRI of 84 consenting prostate and/or bladder cancer patients scheduled for radical prostatectomy were acquired and used to compute apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM: the pure diffusion coefficient D t, the pseudo-diffusion fraction F p and the pseudo-diffusion coefficient D p), and high b value (as acquired and Hessian filtered) parameters within the index lesion. These parameters (separately and combined in a logistic regression model) were used to differentiate lesions depending on whether whole-prostate histopathological analysis after prostatectomy determined a high (≥7) or low (6) Gleason score.Results: Mean ADC and D t differed significantly (p of independent two-sample t test < 0.01) between high- and low-grade lesions. The highest classification accuracy was achieved by the mean ADC (AUC 0.74) and D t (AUC 0.70). A logistic regression model based on mean ADC, mean F p and mean high b value image led to an AUC of 0.74 following leave-one-out cross-validation.Conclusions: Classification by IVIM parameters was not superior to classification by ADC. DW-MRI parameters correlated with Gleason score but did not provide sufficient information to classify individual patients.Key Points: • Mean ADC and diffusion coefficient differ between high- and low-grade prostatic lesions. • Accuracy of trivariate logistic regression is not superior to using ADC alone. • DW-MRI is not a valid substitute for biopsies in clinical routine yet.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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