Diagnostic value of IVIM-MRI for the diagnosis of prostate cancer and benign prostatic hyperplasia

LI Quanlin; ZHANG Cunmei; ZHANG Chenchen; WANG Shanshan; JIANG Jie

Abstract：Objective To evaluate the value of multi-b values double exponential intravoxel incoherent motion imaging(IVIM)mode analysis in the differential diagnosis between benign and malignant prostate lesions.Methods 51 patients with clinically diagnosed prostate cancer and 49 patients with benign prostatic hyperplasia(BPH)underwent abdomen T2-weighted imaging and diffusion-weighted imaging with nine diffusion-sensitive values.We collected them in Shandong Provincial Hospital.We acquired an apparent diffusion coefficient(ADCmono)from the monoexponential model and a diffusion coefficient(ADCs),perfusion coefficient(D*)and perfusion fraction(f)from the biexponential model.Results In all the ROIs,over the full range of b-values,the ADCmono from the monoexponential model was significantly higher than the ADCs from the biexponential model(P<0.001).Prostate cancer had lower ADCmono and ADCs than all the other tissues(P<0.01).The perfusion coefficients from the biexponential model showed a very large variation across this patient population.There were no significant differences between PZ and TU(P=0.231),CG and TU(P=0.389).The perfusion fraction of TU showed a large variation in the data across the patient population.Significant differences between the perfusion fractions(f)of PZ and TU(P=0.041),CG and TU(P<0.001)were detected.When distinguishing prostate cancer from BPH,the AUC of ADCmono was 0.987.It was higher than the ADCs value(AUC=0.966),D * value(AUC=0.469)and f value(AUC=0.816);When differing prostate cancer from PZ,the AUC value of ADCmono(AUC = 0.999)and ADCs(AUC = 1.000)were very similar,and they were higher than the D *(AUC = 0.311)and f(AUC = 0.855).TU ADCmono value(r=-0.767,P<0.05)and ADCs value(r=-0.666,P<0.05)showed a trend of lower with the increase of Gleason scores,and a negative relationship was found.Conclusions The IVIM model can get the ADCs data,which excludes the effect of perfusion from low b-values that can evaluate the actual diffusion of tissue.It is an important point when attributing clinical differences to diffusion within tissues.The ADCmono values and ADCs values of pros-tate cancer are negatively correlated with the Gleason scores,which can support evidence to diagnose and distinguish prostatic diseases,consequently,to monitor the prognosis of prostate cancer.