Abstract
Purpose
To investigate diagnostic efficiency of DWI using entire-tumor histogram analysis in differentiating the low-grade (LG) prostate cancer (PCa) from intermediate–high-grade (HG) PCa in comparison with conventional ROI-based measurement.
Methods
DW images (b of 0–1400 s/mm2) from 126 pathology-confirmed PCa (diameter >0.5 cm) in 110 patients were retrospectively collected and processed by mono-exponential model. The measurement of tumor apparent diffusion coefficients (ADCs) was performed with using histogram-based and ROI-based approach, respectively. The diagnostic ability of ADCs from two methods for differentiating LG-PCa (Gleason score, GS ≤6) from HG-PCa (GS > 6) was determined by ROC regression, and compared by McNemar’s test.
Results
There were 49 LG-tumor and 77 HG-tumor at pathologic findings. Histogram-based ADCs (mean, median, 10th and 90th) and ROI-based ADCs (mean) showed dominant relationships with ordinal GS of Pca (ρ = −0.225 to −0.406, p < 0.05). All above imaging indices reflected significant difference between LG-PCa and HG-PCa (all p values <0.01). Histogram 10th ADCs had dominantly high Az (0.738), Youden index (0.415), and positive likelihood ratio (LR+, 2.45) in stratifying tumor GS against mean, median and 90th ADCs, and ROI-based ADCs. Histogram mean, median, and 10th ADCs showed higher specificity (65.3%–74.1% vs. 44.9%, p < 0.01), but lower sensitivity (57.1%–71.3% vs. 84.4%, p < 0.05) than ROI-based ADCs in differentiating LG-PCa from HG-PCa.
Conclusions
DWI-associated histogram analysis had higher specificity, Az, Youden index, and LR+ for differentiation of PCa Gleason grade than ROI-based approach.
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Wu, CJ., Wang, Q., Li, H. et al. DWI-associated entire-tumor histogram analysis for the differentiation of low-grade prostate cancer from intermediate–high-grade prostate cancer. Abdom Imaging 40, 3214–3221 (2015). https://doi.org/10.1007/s00261-015-0499-4
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DOI: https://doi.org/10.1007/s00261-015-0499-4