The Discussion Of Correlation Between Histogram Analysis Of Quantitative Dynamic Contrast Enhanced And Diffusion Weighted MRI And Gleason Score Of Prostate Cancer

Part? The analysis of correlation between histogram analysis of DCE-MRI and IVIM-DWI quantitative parameters and Gleason scores of prostate cancer and their evaluation of preliminary applicationObjective:Todiscuss the value and diagnostic efficiency of the histogram analysis of quantitative dynamic enhanced MRI(DCE-MRI)and IVIM-DWI parameters for discriminating the low and intermediate/high Gleason score of prostate cancer.Materials and Methods: A total of 50 patients went transrectal ultrasound guided prostate systemic biopsy and pathologically confirmed as prostate cancerwho had routine,DCE and DWI-MRI(multiple b values)scans at 3.0T MR between May 2015 and May 2016 were retrospectivelyanalyzed,the focus of cancer was post-processed by DCE-MRI and IVIM-DWI for quantitative analysis,The set of ROI was 3D whole volume,along the scale of lesion manually outline the ROI on T2 WI images step by step,and then the ROI was mapped to the corresponding DCE-MRIand IVIM-DWI images by image registration,DCE-MRI quantitative analysis parameters Kep,Ktrans,Ve and IVIM-DWI quantitative parameters D,f,D * of the lesions were also achieved respectively,then the Histogram analysis was performed to get the mean,median,25 th percentile,75 th percentile,skewness and kurtosis.Using the Spearman rank correlation analysis to evaluate the correlation of histogram analysis of quantitative parameters and Gleason score of prostate cancer.At the same time the parameters related to Gleason scores of prostate cancer were chose inthese histogram analysis results of quantitative parameters above.Thediagnostic performance of identifying low-grade(LG,GS ?6)and intermediate/high-grade Gleason score(HG,GS > 6)of prostate cancer was carried by receiver operating characteristic(ROC)curve.Results: Of 50 patients with prostate cancer,Gleason score?6was 14,Gleason score 7 was19,Gleason score ?8was 17.The Kep and Ktrans(mean,median,25 th,75th)was correlated with Gleason score of prostate cancer(r value was 0.323~0.752,P < 0.05).The D(mean,median,25 th,75th)was correlated with Gleason score of prostate cancer(r value is-0.388~-0.527,P < 0.05).D(skewness,kurtosis)was positivelycorrelated with Gleason score of prostate cancer(r value is 0.413/0.402,P < 0.05).The correlation between histogram analysis of D*and f and Gleason scoreof prostate cancer had no statistical significance(P > 0.05).The diagnosis efficiency of histogram analysis of DCE-MRI and IVIM-DWI quantitative parameter values in identifying LG and HG prostate cancer cancer showed that the area under the curve of Kep(25 th)and D(25 th)were larger,and were 0.958 and 0.873 respectively,the area under the curve were not statistically different between Kep(25 th)and D(25 th)(Z value is 1.445,P > 0.05).Conclusions: This study showed that the histogram analysis results(mean,median,25 th,75 th)of quantitative parameters(Kep,Ktrans)of DCE-MRI and the histogram analysis(mean,median,25 th,75 th,skewness,kurtosis)of quantitative parameters(D)of IVIM-DWI were correlated with Gleason score of prostate cancer,but the the diagnostic efficiency of histogram analysis of DCE-MRI and IVIM-DWI quantitative parameter had no significantly statistical difference in identifing LG and HG groups of prostate cancer,both of them can help to preoperatively evaluate the Gleason score of prostate cancer.Part ? The discussion of correlation between Histogram analysis of quantitativemono-exponential,bi-exponential and diffusion kurtosis models in Diffusion weighted imaging and Gleason score of prostate cancerObjective:To discuss the correlation between Histogram analysis of quantitative mono-exponential,bi-exponential and diffusion kurtosis models in Diffusion weighted imaging and the Gleason score of prostate cancer,and evaluate the applation value and diagnostic efficiency in identifying low from intermediate/high Gleason scoreof prostate cancerMaterials and Methods:50 patients with histologically confirmed as prostate cancer were examined using DWI performed at3 T employing an extended b-value range from 0 to 2000 s/mm2.Tumors were classified into three groups: Gleason score ?6(n=14),Gleason score =7(n=19),Gleason score? 8(n=17).Data were post-processed by whole tumor histogram analysis,the ROI was manually drown in DWI(b = 1000 s/mm2)step by step along the outline of cancer,and quantitative analysis were performed respectively by mono-exponential,bi-exponential and diffusion kurtosis modelsfor quantification of apparent diffusion coefficients(ADCs),diffusivity D,pseudo-diffusivity D*,perfusion fraction f,diffusion coefficients by non-Gaussian distribution(Dk)and kurtosiscoefficient(K).Then the Histogram analysis was performed to get the mean,median,25 th percentile,75 th percentile,skewness and kurtosis.The correlation between histogram analysis results of these quantitative parameters and Gleason score of prostate cancer were evaluated by Spearman correlationcoefficient.Areasunder receiver operating characteristic curve(AUCs)were estimated to evaluate performance in Gleasonscore classifications.The diagnostic performance of histogram analysis results of each quantitative parametersin identifying low(lowgrade,LG,Gleason score?6)and high(intermediate/high grade,HG,Gleason score > 6)Gleason score of prostate cancer was performed by comparing the area under the ROC curve and the curve values.Results: There were 14 for GS ?6,19 for GS= 7 and 17 for GS ?8 at pathological findings of 50 patients with prostate cancer.The values of ADC and Dk(mean,median,25 th,75 th)were negatively correlated with Gleason score of prostate cancer(r value is 0.452 ~ 0.624,P < 0.05).The values of D(mean,median,25 th,75 th)had a certain correlation with Gleason score of prostate cancer(r value is-0.388 ~-0.529,P < 0.05).The values of D(skewness and kurtosis)had a certain correlation with Gleason score of prostate cancer(r value were 0.413/0.402,P < 0.05).The histogram analysis results of D* and f had no statistically significant correlation with Gleason score of prostate cancer has no(P > 0.05).The values of K(mean,median,25 th,kurtosis)were positively correlated with Gleason score of prostate cancer(r value was 0.423 ~ 0.423,P < 0.05).The diagnostic efficiency of histogram analysis results of these quantitative parameter values in identifying LG and HG prostate cancer showed that the ADC(median),D(25 th),Dk(mean)and K(25 th)had a larger area under the curve,and were 0.844,0.873,0.815 and 0.919,respectively,thedifferences of area under the curve between any two ofthese parameters above were not statistically significant(P > 0.05).Conclusions: The results of this study showed that the histogram analysis resul ts(mean,median,25 th,75 th)of quantitative mono-exponential model(ADC),the histogram analysis results(mean,median,25 th,75 th,skewness,kurtosis)of quantit ativebi-exponential model(D)and histogram analysis results(mean,median,25 th,75 th)of quantitative diffusion kurtosis model(Dk)and histogram analysis results(mean,median,25 th,kurtosis)of quantitative diffusion kurtosis model(K)were all correlated with Gleason score of prostate cancer,other than mono-exponential and bi-exponentialmodel,diffusion kurtosis model contained two parameters which were correlated with Gleason score of prostate cancer,but the diagnostic efficiency of h istogram analysis results of quantitative parameters were not obvious different amon g these mono-exponential model and bi-exponentialmodel,diffusion kurtosis model a bove in identifying LG and HG prostate cancer,all of these three diffusion model c ould help with the preoperative evaluation of Gleason score of prostate cancer.