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

Barbieri, Sebastiano; Brönnimann, Michael; Boxler, Silvan; Vermathen, Peter; Thöny, Harriet C. (2017). Differentiation of prostate cancer lesions with high and with low Gleason score by diffusion-weighted MRI. European radiology, 27(4), pp. 1547-1555. Springer 10.1007/s00330-016-4449-5

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology
04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology > DCR Magnetic Resonance Spectroscopy and Methodology (AMSM)

UniBE Contributor:

Barbieri, Sebastiano; Brönnimann, Michael; Boxler, Silvan; Vermathen, Peter and Thöny, Harriet C.

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0938-7994

Publisher:

Springer

Language:

English

Submitter:

Christoph Hans Boesch

Date Deposited:

21 Mar 2017 10:30

Last Modified:

21 Mar 2017 10:30

Publisher DOI:

10.1007/s00330-016-4449-5

PubMed ID:

27300199

Uncontrolled Keywords:

ADC; Diffusion-weighted MRI; IVIM; Logistic regression; Prostate cancer

BORIS DOI:

10.7892/boris.93296

URI:

https://boris.unibe.ch/id/eprint/93296

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