Study On The Diagnostic Value Of IVIM-DWI Combined With PI-RADS V2 In Peripheral Prostate Cancer

Objective:To investigate the quantitative parameters of intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI),the second edition of the Prostate Imaging Reporting and Data System Version 2(PI-RADS V2)and their combined diagnostic value for peripheral zone prostate cancer(PCa).Materials and methods:The clinical data of 51 patients with peripheral prostate lesions confirmed by ultrasound-guided biopsy were retrospectively analyzed,including 27 patients with prostate cancer(malignant group),36 patients with benign prostatic hyperplasia(BPH)and/or chronic prostatitis(benign group).All patients were scanned with conventional MRI and IVIM-DWI.Fourteen b values(b = 0,25,50,75,100,150,200,400,600,800,1000,1200,1500,2000s/mm2)were used for IVIM-DWI.Apparent diffusion coefficient(ADC),pure water molecular diffusion coefficient(D value),perfusion correlation diffusion coefficient(D*value)and perfusion fraction(f value)were calculated by GE ADW4.6 Functool post-processing software,and PI-RADS V2 scores were performed for each lesion.Independent sample t test was used to compare the difference of parameters between PCa and BPH groups.The difference of parameters between PCa and BPH groups was statistically significant.Subject operating characteristic curve(ROC)was established to analyze the diagnostic efficacy of parameters for prostate cancer.Results:1.There were significant differences in ADC,D and f quantitative parameters between PCa group and BPH group(P < 0.05),and the parameters of PCa group were significantly lower than those of BPH group.There was no significant difference in D* between groups(P=0.581).Quantitative parameters ADC and D of IVIM are of high value in the diagnosis and differential diagnosis of benign and malignant lesions of the prostate with peripheral zone,and ADC value is the best value in the diagnosis of benign and malignant lesions of the prostate.2.When divided into three thresholds,the sensitivity,specificity,positive predictive value and negative predictive value of PI-RADS V2 score for peripheral benign and malignant lesions of prostate were 85.19%,80.56%,76.67% and 87.88%,respectively.3.PI-RADS V2 score combined with ADC value had the highest diagnostic efficacy for peripheral prostate cancer,with sensitivity,specificity,positive predictive value and negative predictive value of 85.19%,94.44%,92.00%,89.48%,respectively.Conclusions: 1.IVIM derivative parameters ADC value,D value and PI-RADS V2 score have higher diagnostic and differential value for peripheral benign and malignant lesions of prostate,and ADC value has the best diagnostic efficiency.2.PI-RADS V2 score combined with ADC value has high diagnostic efficiency and specificity for peripheral prostate cancer,which can effectively predict and judge the clinical puncture indications of patients.