Identification and Localization of Prostate Cancer with Combined Use of T2-Weighted, Diffusion Weighted MRI and Proton MR Spectroscopy, Correlation with Histopathology

Abstract

<b><span>Purpose</span></b><b><span>: </span></b><span>To predict the diagnostic performance of combined use of T2-</span><span>weighted imaging</span><span> </span><span>(T2W)</span><span>-</span><span>diffusion weighted MRI</span><span> </span><span>(DWI)</span><span> </span><span>and apparent diffusion coefficient</span><span> </span><span>(ADC)-proton MR spectroscopy</span><span> </span><span>(H-MRS)</span><span> for the detection of prostate cancer, correlated to histopathology as the reference standard.</span><span> </span><b><span>Method</span></b><b><span>:</span></b><span> After institutional review board approval<span>,<i> </i></span>40 patients with prostate cancer were included in this retrospective research. Two readers evaluated the results of T2W, DWI-ADC mapping and H-MRS independently for the depiction of prostate cancer. Reference standard was the TRUS-</span><span>guided biopsy and the surgical histopathological results. Statistical analysis was assessed by Fisher’s exact t-test, Wilcoxon signed rank test, variance analysis test with Kappa (k) values<b> </b>and<b> </b>receiver operating characteristics (ROC) curve for ADC values, Cho/Cit and Cho</span><span> </span><span>+</span><span> </span><span>Cre/Cit ratios for each observer.<span> <b>Results</b></span></span><b><span>:</span></b><span> Both readers declined </span><span>46% sensitivity and 68% specificity for T2W sequence, 29% sensitivity and 82% specificity for DWI-ADC mapping and 49% specificity for </span><span>Cho/Cit and Cho</span><span> </span><span>+</span><span> </span><span>Cre/Cit </span><span>ratios, 69% sensitivity for </span><span>Cho/Cit 70% sensitivity for Cho</span><span> </span><span>+</span><span> </span><span>Cre/Cit ratios of H-MRS.</span><b><span> </span></b><span>T2W</span><span> </span><span>+</span><span> </span><span>DWI-ADC mapping</span><span> </span><span>+</span><span> </span><span>H-MRS (</span><span>Cho/Cit and Cho</span><span> </span><span>+</span><span> </span><span>Cre/Cit ratios) regarded 81% sensitivity and 66% specificity, with significant statistical differences to the reference histopathology</span><span> </span><span>(p</span><span> </span><span><</span><span> </span><span>0.05). <b>Conclusion</b></span><b><span>:</span></b><span> Combination of T2W, DWI and H-MRS were more sensitive and more accurate than either sequences alone, for prostate cancer localization and detection.</span><span></span

A complete automated algorithm for segmentation of tissues and identification of tumor region in T1, T2, and FLAIR brain images using optimization and clustering techniques

“…Fully automatic brain extraction algorithm for axial T2‐weighted MR images recommended by Somasundaram and Kalaiselvi () performs image segmentation only upon T2‐weighted images using brain extraction algorithm (BEA). Identification and localization of prostate cancer with combined use of T2‐weighted, diffusion‐weighted MRI and proton MR spectroscopy, correlation with histopathology proposed by Hekimoğlu et al () segments T2‐weighted and MRS (MR spectroscopy) images. Sensitivity, specificity, and signal‐to‐noise ratio values produced by the above said algorithm needs to be enhanced.…”