Study On The Diagnostic Value Of Combined Use Of Dti And Mrs For The Prostate Cancer

Objective: To evaluate the combination value of duffusion tensorimaging (DTI) and the three dimensional hydrogen proton MR spectroscopy(3D-1H-MRS) for the diagnosis of prostate cancer (PCa) at3.0T magneticresonance imaging (MRI).Methods:45patients with highly suspicious of PCa underwent DTIand3D-1H-MRS in the mean time, MRI data were correlated to pathologyresults. Observe the apparent diffusion coefficients (ADC) maps, fractionalanisotropy (FA) maps, diffusion tensor tractography (DTT) maps and thechanges of spectrums. The average values of ADC, FA and(Choline+Creatinine)/Citrate (CC/C) in cancerous and noncancerous sectionsof the peripheral zone (PZ) and the central gland (CG) were meaured.Logistic regression were used to construct diagnostic models, the areas underthe receiver operating characteristic (ROC) curve (AUC) were comparedbetween ADC, FA, DTI, MRS,“DTI combined with MRS” in PZ and CG.Calculate the sensitivity, specificity, positive predictive value and negativepredictive value of DTI, MRS,“DTI and MRS”,“DTI or MRS”.Results:38patients acquired images that can be analysed. The cancerous lesions showed hypointensity or slightly low signal on ADC maps,and hyperintensity or slightly high signal on FA maps. The fiber bundles arein a mess with splitting and irregular abnormal color on DTT and FAcolorous maps. On MRS, PCa is characterized by elevated Cho peaks ondifferent extent, reduced or disappeared Cit peaks on different extent.Whether in PZ or CG, the ADC value of cancerous sections was significantlylower than noncancerous sections (P＜0.01)，while the FA and CC/C valuewere significantly higner than noncancerous sections (P＜0.01, P＜0.05). Inthe PZ, the AUC for “DTI combined with MRS” was significantly higherthan that for either DTI or MRS alone (P＜0.01). In the CG，the AUC for“DTI combined with MRS” was significantly higher than that DTI (P＜0.01)alone, but no difference than MRS alone (P＞0.05).“DTI and MRS” had thehignest specificity both in PZ and CG，significantly higher than that foreither DTI or MRS (P＜0.05).“DTI or MRS” had the hignest sensitivity,significantly higher than MRS in the PZ (P＜0.01) and significantly higherthan DTI in the CG (P＜0.01).Conclusion: The combination of DTI and3D-1H-MRS is helpful forimproving the dignostic efficiency of PCa.