Study on diagnostic value of ultra-high b-value ADC images combined with PSAD for lesions in prostate central gland region
YE Fei
HUANG Honglei
FAN Zhengrong
LI Feng
Abstract：Objective To explore the diagnostic value of ultra-high b-value apparent diffusion coefficient(ADC)images combined with prostate-specific antigen density(PSAD)for lesions in the prostate central gland region.Methods A retrospective analysis was conducted on the clinical data of 106 patients with suspected prostate cancer(PCa)and undergoing routine magnetic resonance imaging(MRI)examination for the prostate and diffusion-weighted imaging(DWI)examination with a b-value of 3 000 s/mm2 from July 2023 to March 2025 in Nanping First Hospital Affiliated to Fujian Medical University.The lesions were located in the central gland region of the prostate and were scored 3-5 points according to the Prostate Imaging Reporting and Data System(PI-RADS)version 2.1.The mean ADC(ADCmean),minimum ADC(ADCmin),and relative deviation(RD)were obtained.The levels of prostate-specific antigen(PSA)were detected by using chemiluminescent immunoassay,and PSAD was calculated.Results Among the 106 patients,54 patients were diagnosed with central gland prostate cancer(CGPCa)(CGPCa group)by pathological examination,and 52 patients were diagnosed with benign prostatic hyperplasia(BPH)(BPH group)by pathological examination.The levels of ADCmin and ADCmean in the CGPCa group were lower than those in the BPH group,while the levels of RD,PSA and PSAD in the CGPCa group were higher than those in the BPH group,with statistically significant differences(P＜0.05).The results of receiver operating characteristic(ROC)curve analysis showed that ADCmin,ADCmean,RD,PSA and PSAD could effectively differentiate CGPCa from BPH(P＜0.05).The 3 indicators(ADCmin,RD and PSAD)having higher diagnostic efficiency were selected to construct a combined diagnostic model.The results of DeLong's test showed that the diagnostic efficiency of the combination of the three indicators was higher than that of a single indicator(Zthree-indicator combination-ADCmin=1.968,P=0.049;Zthree-indicator combination-PSAD=2.081,P=0.037;Zthree-indicator combination-RD=1.992,P=0.046),with a sensitivity of 74.07%and a specificity of 100.00%.Conclusion The diagnostic model constructed on basis of ADCmin,RD and PSAD exhibits significant advantages in differentiating CGPCa from BPH,enhancing the diagnostic efficiency for lesions in the central gland region of the prostate.This model provides a novel methodological strategy for accurately distinguishing CGPCa from BPH and has good clinical application value.
Keywords：Central gland prostate cancer(CGPCa)Benign prostatic hyperplasia(BPH)Ultra-high b-valueApparent diffusion coefficient(ADC)Relative deviation(RD)Prostate-specific antigen density(PSAD)
Publication Date：2025-10-30
Online Publishing Date：2025-11-13(First online date of this platform, not the publication date of the document)
Pages：5( 1126-1130 )