Threshold-based parametric analysis of diffusion-weighted magnetic resonance imaging at 3.0 Tesla to identify men with prostate cancer

Abstract

Abstract:The aim of this study is to determine the accuracy of three apparent diffusion coefficient (ADC) threshold values in detecting prostate cancer (PCa) prior to prostate biopsy. Sixty men with clinical suspicion of PCa underwent endorectal diffusion-weighted magnetic resonance imaging (DW-MRI) at 3.0 Tesla (T). Three ADC threshold values (tADC: 1.0, 1.2 and 1.4 × 10 −3 mm 2 /s) were sequentially applied to ADC maps for the detection of malignant lesions in the prostatic peripheral zone (PZ). Segment-based and patient-specific PCa detection performance of these tADC values was correlated with the histopathological results from the subsequent 12-core transrectal ultrasound (TRUS)-guided biopsy. Mean of ADC and area size of the identified malignant region of interests (ROIs) were recorded. Accuracy for PCa detection was assessed by receiver operating characteristic curves. 1.0 × 10 −3 mm 2 /s of tADC provided 79% sensitivity, 97% specificity and 93% positive predictive value for PCa. Area size of the malignant ROI was a good independent factor for PCa detection (Area under curve, AUC = 0.85). ROI area size 0.2 cm 2 was identified as the best