Study on the Diagnostic Value of Quantitative Parameters of Dynamic En-hanced Magnetic Resonance Imaging Combined with Apparent Diffusion Coefficient Values for Peripheral Prostate Cancer

LIU Tingting; WANG Xiaohui; WANG Hongxing; PAN Feng; LI Hao; HU Haifeng

doi:10.3969/j.issn.1002-3429.2024.13.015

Abstract：Objective To explore the value of combined quantitative parameters of dynamic contrast-enhanced mag-netic resonance imaging(DCE-MRI)combined with apparent diffusion coefficient(ADC)values in the diagnosis of early pe-ripheral prostate cancer.Methods In total,31 patients with early peripheral prostate cancer diagnosed by biopsy pathology from February 2019 to December 2021 and 27 patients with prostatitis were selected.All patients underwent DCE-MRI exami-nation for quantitative parameters,and the pathological examination results were used as the gold standard to analyze the DCE-MRI characteristics of different patients.The area under receiver operating characteristic(ROC)curve(AUC)was used to analyze the diagnostic value of quantitative parameters of DCE-MRI and diffusion weighted imaging(DWI)sequences for early peripheral prostate cancer and prostatitis.Results In 31 patients with prostate cancer,T2-weighted imaging(T2WI)mainly showed nodular low signal in peripheral zone,accounting for 58.06%.DWI was characterized by nodular and diffuse high sig-nal,and ADC value decreased,accounting for 51.61%.DCE-MRI showed early enhancement of the lesion,with the with-drawal of contrast agent after delay,and the enhancement curve was mainly outflow type,accounting for 64.52%.In 27 pa-tients with prostatitis,unilateral or bilateral diffuse low signal in peripheral zone was the main feature on T2WI,accounting for 51.85%.In DWI,the irregular high signal of peripheral band was found on one or both sides,and ADC value decreased mainly,accounting for 59.26%.DCE-MRI showed early enhancement of the lesion,and the contrast agent withdrawal was not obvious after delay,and the enhancement curve was mainly inflow type,accounting for 81.48%.The ADC value of early pe-ripheral prostate cancer was lower than that of prostatitis,and the rate constant(Kep)and metastasis constant(Ktrans)were higher than those of prostatitis(P＜0.05).The AUC of quantitative parameters of DCE-MRI combined with ADC value in the diagnosis of early peripheral prostate cancer was 0.862(95%CI:0.659,0.865),with sensitivity of 87.10%,specificity of 81.48%,accuracy of 84.48%,positive predictive value of 84.38%,and negative predictive value of 84.62%.Conclusion Quantitative parameters of DCE-MRI combined with ADC values are effective in the diagnosis of early peripheral prostate cancer,which can significantly improve the clinical detection rate and provide a reference for the diagnosis and treat-ment of the disease.