FMRI Multiple Parameters Analysis In Prostate Cancer And Correlation With PSA And Gleason Grading

Part1Analysis of functional magnetic resonance imagingmultiple parameters in prostate cancerObjective: To evaluate the diagnostic value of3.0T magnetic resonance dynamiccontrast-enhanced imaging （DCE） and diffusion weighted imaging （DWI） in prostatecancer.Materials and Methods: A retrospective analysis was conducted in62patients afterprostate MRI check, contained35cases prostate cancer （PCa） and27cases benignprostate hyperplasia （BPH） confirmed pathologicaly. All patients performed conventionalMR, dynamic enhanced and DWI. The signal changes and time-signal intensity curve（TIC） were evaluated. Then the mean values of signal intensity to_peak(SI_peak), the meantime to_peak(T_peak), maximum slope of increase（MSI）, signal enhancement ratio（SER）,apparent diffusion coefficient（ADC） and index of apparent diffusion coefficient（EADC）of the lesions were measured and compared between two groups. The differentialdiagnostic value of these parameters were analyzed. The receiver operator characteristiccurve（ROC） of the patients were used to definite the thresholds.Results: The SI_peak, T_peak, MSI and SER of BPH and PCa were （485.69±80.80）vs（506.33±65.91）,（8.3±2.7）s vs （6.9±1.7）s,（188.31±36.86） vs （215.69±59.66）, and（109.14±13.78） vs （121.71±20.82）, respectively. The ADC and EADC value of BPH andPCa were （1.0±0.24）×10^-3mm²/s vs （0.7±0.22）×10^-3mm²/s, and（0.36±0.09）vs（0.49±0.09）, respectively. The mean values of T_peak, MSI, SER, ADC, EADC weresignificantly different between PCa and BPH, but there was no significantly differencebetween two groups.The ROC areas of T_peak,MSI,SER,ADC were0.624,0.634,0.676and0.839, approximately. And the ADC value had better diagnosis values. The diagnosisthresholds of SER and ADC were113.34and0.9×10^-3, and the sensitivity, the specificity and the accuracy were（65.7%,63%,64.2%） and （77.8%,82.9%,80.7%）.In PCa, the TIC was typeⅠin two cases, type Ⅱ in eleven cases, and, type Ⅲ intwenty-two cases. In BPH, six cases with typeⅠ, eighteen cases with type Ⅱ, and threecases with type Ⅲ. TIC type was significantly different between two groups. Maked typeⅢ as PCa diagnosis standard, the sensitivity, the specificity and the accuracy were63%,89%and74%.Conclusions：（1） DWI and DCE-MRI both played important roles of diagnose and differentiate in theprostate cancer.（2） ADC had better diagnosis performances than any other parameters.（3）T_peak, MSI and SER had certain values of the diagnose and differentiate in the prostatecancer, but the diagnostic performances were poor.（4） TIC plays important role of the diagnosis in the prostate cancer. Part2Correlation of functional magnetic resonance imagingparameters with PSA and Gleason grading inprostate cancerObjective: To analysis the relationship of the parameters of DCE MR and DWI withPSA and Gleason grading, and to explore the feasibility of prognosis of prostate cancer invivo with MR imaging.Materials and Methods: A total of32patients with prostate cancer performed withconvential MRI, dynamic enhanced and DWI. The mean values of signal intensity to Peak(SI^peak), the mean time to^peak(T^peak),maximum slope of increase（MSI）, signalenhancement ratio（SER） were calculated from DCE MR images; and apparent diffusioncoefficient（ADC） and index of apparent diffusion coefficient of the lesions weredetermined from DWI. Collected the PSA value before surgery and postoperative Gleasonclassification. The correlation between each other was analyzed.Results: There was a significant positive correlation of the value SI^peakwith MSI andSI^peakwith PSA. There was a significant negative correlation of PSA with ADC and ADCwith Gleason rating. No such correlation has been found between other parameters withPSA or Gleason rating.Conclusions:（1）ADC and PSA have good diagnostic value for prostate cancer, combination them cansignificantly improve diagnosis of prostate cancer.（2）The value of ADC contribute to the preliminary assessment of biologicalcharacteristics in prostate cancer.