Differentiation Of Central Gland Prostate Cancer From Benign Prostatic Hyperplasia By Using Monoexponential,Biexponential Diffusion-weighted Imaging And Dynamic Contrast-enhanced MRI With Tofts Model

Part 1:Differentiation of central gland prostate cancer from benign prostatic hyperplasia by using monoexponential and biexponential diffusion-weighted imagingObjective:To assess the value of parameters derived from monoexponential and biexponential diffusion-weighted imaging(DWI)(parameter derived from monoexponential DWI:ADCtotal;parameters derived from biexponential DWI: ADCslow?ADCfast?f)for distinguishing central gland(CG)prostate cancer from benign prostatic hyperplasia(BPH).Material and method:The MRI and clinical dates of 36 patients with CG prostate cancers ?25 patients with stromal hyperplasia(SH)and 23 patients with glandular hyperplasia(GH)were retrospectively analyzed,who were proved by prostate biopsy.MRI examinations include multiple-b-value(0?50?100?150?200?500?800?1000?1500?2000 s/m m2)DWI.Drawing the region of interested(ROI),we could measure the values of ADCtotal?ADCslow?ADCfast and f for the three pathological types.Then we analysised the variation of the ADCtotal ?ADCslow?ADCfast?f among CG prostate cancer?SH and GH.By using the receiver operating characteristic(ROC)curves,the diagnostic performances of ADCtotal ? ADCslow?ADCfast and f were calculated in differentiating central gland prostate cancer from benign prostatic hyperplasia.Results: There were significant differences in both ADCtotal and ADCslow among the three groups(P<0.0001),while ADCfast was not(P=0.685).There was significant difference in f value between CG prostate cancer and SH(P=0.002)only.In differentiating central gland prostate cancer from benign prostatic hyperplasia,both the diagnostic performances of ADCtotal and ADCslow were high,but the diagnostic performance of f value was low.Conclusion: In differentiating central gland prostate cancer from benign prostatic hyperplasia,parameter derived from monoexponential DWI(ADCtotal)and parameter derived from biexponential DWI(ADCslow)both showed high diagnostic performance.Part 2:Differentiation of central gland prostate cancer from benign prostatic hyperplasia by using dynamic contrast-enhanced MRI with Tofts ModelObjective : To assess the value of parameters derived from dynamic contrast-enhanced MRI(DCE-MRI)for distinguishing central gland(CG)prostate cancer from benign prostatic hyperplasia(BPH).Material and method:The MRI and clinical dates of 36 patients with CG prostate cancers ?25 patients with stromal hyperplasia(SH)and 23 patients with glandular hyperplasia(GH)were retrospectively analyzed,who were proved by prostate biopsy.MRI examinations include DCE-MRI.Analysis the variation of the Ktrans?Kep?Ve among CG prostate cancer?SH and GH.By using the receiver operating characteristic(ROC)curves,the diagnostic performances of Ktrans? Kep and Ve were calculated in differentiating central gland prostate cancer from benign prostatic hyperplasia.Results: There were significant differences in both Ktrans and Kep among the three groups(P<0.0001).There was significant difference in Ve value between CG prostate cancer and GH,GH and SH(P<0.0001).In differentiating central gland prostate cancer from benign prostatic hyperplasia,both the diagnostic performances of Ktrans and Kep were moderate,but the diagnostic performance of f value was low.Conclusion: In differentiating central gland prostate cancer from benign prostatic hyperplasia,the diagnostic performances of Ktrans and Kep were moderate,but the diagnostic performance of f value was low.Part 3:Combined monoexponential,biexponential DWI and dynamic contrast-enhanced MRI with Tofts Model to diagnose central gland prostate cancer and the correlations between these parametersObjective:To assess the value of combined monoexponential,biexponential DWI and dynamic contrast-enhanced MRI with Tofts Model to diagnose central gland prostate cancer and the correlations between these parameters.Material and method:The MRI and clinical dates of 36 patients with CG prostate cancers and 30 patients with benign prostatic hyperplasia(BPH)were retrospectively analyzed,who were proved by prostate biopsy.MRI examinations performed before biopsy include T1WI?T2WI?multiple-b-value DWI and DCE-MRI.Statistical analysis was performed with logistic regression analysis and Pearson correlation analysis.Results: The value of combined monoexponential,biexponential DWI and dynamic contrast-enhanced MRI with Tofts Model to diagnose central gland prostate cancer was similar to that of ADCtotal alone.Except the significant correlation between ADCtotal and ADCslow,there were not other significant correlations among parameters derived from monoexponential DWI ? biexponential DWI and dynamic contrast-enhanced MRI with Tofts Model in central gland prostate cancer.Conclusion: The diagnostic value of combined monoexponential,biexponential DWI and dynamic contrast-enhanced MRI with Tofts Model in central gland prostate cancer was similar to that of ADCtotal alone.In central gland prostate cancer,DWI shows no significant correlation with Tofts Model perfusion parameters derived from the DCE-MRI.