| Purpose:The study is through the research of the different dimensional(axial,sagittal,and coronal)DWI and ADC values of prostate tissue,to evaluate the value of multi-dimensional DWI and ADC values for the diagnosis and assessment of aggressiveness of prostate cancer,aiming to further improve diagnosis and evaluation of prostate cancer by DWI.Methods:A total of 120 patients with suspected prostate cancer who underwent MR examination were enrolled in the Second Hospital of Tianjin Medical University,including 71 prostate cancer lesions and 56 benign prostate lesions were enrolled.In all cases,the MR imaging data of multi-dimensional DWI and related clinical data were collected.The ADC values of the prostate cancer foci and benign prostatic foci were measured by post-processing workstation.(1)Doctors interpreted the multi-directional DWI images of 71 prostate cancer lesions and evaluated whether the multi-dimensional DWI images showed differences in the display of tumor focus and its surrounding tissues.(2)According to whether there are differences in the display of cancer foci by multi-dimensional DWI images,71 prostate cancer lesions were divided into two groups:group 1(difference group)and group 2(no difference group).The Student’s t test and rank-sum test were used to compare the ADC values at different orientations in each group,to verify the similarities and differences of the multi-dimensional DWI images in the two groups.Meanwhile,Student’s t test,rank sum test or chi square test were used to compare the image features and laboratory indexes between the two groups,to explore the significance of the differences in multi-dimensional DWI images in group 1.(3)Rank sum test,Student’s t test,Spearman rank correlation analysis and ROC curve were used to analyze the ADC values of 127 lesions,to evaluate and compare the efficacy of multi-dimensional ADC values for the detection and assessment of aggressiveness of prostate cancer.Results:(1)The display of multi-dimensional DWI is different in partial prostate cancer foci,and it can more accurately assess the invasion of the surrounding tissues of prostate cancer.(2)There was a significant difference between the transverse and sagittal ADC values in group 1(P=0.030),while there was no significant difference among the ADC values of different directions in group 2.The size of cancer foci in group 1 was significantly smaller than that in group 2(2.25 vs.3.67,P=0.001),and most of the foci were mostly located in the peripheral zone(?~2=9.200,P=0.010)with a regular shape(?~2=6.292,P=0.043).TPSA and f PSA in group 1 were significantly lower than those in group 2(34.691 vs.57.213,P=0.028;3.514 vs.6.249,P=0.007),while testosterone was significantly higher than those in group 2(5.364 vs.3.825,P=0.004).(3)There were significant differences in the multi-dimensional ADC values between benign and malignant prostate tissues(P(27)0.0001).The diagnostic efficacy of multi-dimensional ADC values alone or in combination was similar to that of transverse ADC values.However,combined with three-dimensional ADC values yields the greatest AUC and sensitivity(0.974 and91.55,respectively),while sagittal or coronal ADC yields the greatest specificity(98.21).There was significant negative correlation between ADC in different directions and Gleason score of prostate cancer(transverse r=-0.580,sagittal r=-0.402,coronal r=-0.522,P(27)0.001).Multi-dimensional ADC values alone or in combination has the same efficacy in evaluating the aggressiveness of prostate cancer.However,combined with three-dimensional ADC yields the greatest AUC and specificity(0.820 and 92.31%,respectively),while sagittal ADC values alone yields the greatest sensitivity(75.56%).Conclusions:(1)There are differences in the display of partial prostate cancer foci by multi-dimensional DWI images,suggesting that sagittal and coronal DWI may provide additional information for the diagnosis of prostate cancer.In addition,multi-dimensional DWI provides more complete information for the clinic,which is conducive to the assessment of prostate cancer’s invasion of surrounding tissues.(2)Multi-dimensional DWI and ADC values may be helpful for the detection of prostate cancer in patients with low risk or tiny prostate cancer foci,and have a certain role in improving the application value of MRI in the early diagnosis of prostate cancer.(3)Multi-dimensional ADC values can provide more comprehensive information than traditional single-axis ADC value and have a certain application value in improving the diagnosis and evaluation of aggressiveness of prostate cancer. |
