Added Value of Apparent Diffusion Coefficient Histogram in Predicting Extraprostatic Extension of Prostate Cancer
10.3969/j.issn.1005-5185.2024.09.014
- VernacularTitle:表观扩散系数直方图对评估前列腺癌包膜外侵犯的附加价值
- Author:
Honghao XU
1
,
2
;
Baichuan LIU
;
Xiaohui DING
;
Xiaojing ZHANG
;
Haiyi WANG
;
Huiyi YE
Author Information
1. 解放军医学院,北京 100853
2. 解放军总医院第一医学中心放射诊断科,北京 100853
- Keywords:
Prostatic neoplasms;
Magnetic resonance imaging;
Diffusion weighted imaging;
Apparent diffusion coefficient;
Extraprostatic extension;
Pathology,surgical;
Cross-sectional study
- From:
Chinese Journal of Medical Imaging
2024;32(9):938-944
- CountryChina
- Language:Chinese
-
Abstract:
Purpose To explore the additional value of apparent diffusion coefficient(ADC)histogram in predicting extraprostatic extension(EPE)of prostate cancer.Materials and Methods Consecutive patients undergoing multi-parameter MRI and subsequent radical prostatectomy from January 2021 to December 2022 were retrospectively included in this study.Two radiologists independently estimated EPE by using national cancer institute grading system for extraprostatic extension(EPE grade system),with disagreement resolved by discussion.Histogram metrics were derived from three-dimensional volumes of interest encompassing the entire lesion on ADC maps using FireVoxel,obtaining mean ADC,1st,5th,10th,25th,50th,75th,90th,95th and 99th ADC values.The ADC histograms between the groups with and without EPE were compared.Multivariable Logistic regression analysis was used to identify the independent predictive factors of EPE,and a combined model was developed.Receiver operator characteristic curve was used to evaluate the diagnostic performance,and the area under the curve was calculated and compared.Results Thirty-four patients(34％)had pathologic confirmed EPE after radical prostatectomy.ADC histogram parameters showed significant differences between patients with and without EPE(P＜0.05).Multivariate Logistic regression analysis revealed 99th ADC(OR=0.609,P=0.008)and EPE grade system(OR=4.158,P＜0.001)were independent predictors of EPE.For predicting EPE,the area under the curve of 99th ADC,EPE grade system and the combined model were 0.756,0.805 and 0.856,respectively.The area under the curve of 99th ADC and the EPE grade system in identifying EPE showed no significant difference.The diagnostic efficacy of combined model was significantly superior to that of 99th ADC or EPE grading system(Z=2.223,2.208,both P＜0.05).Conclusion The ADC histogram parameters demonstrate additional value for preoperative prediction of EPE.Combining the 99th ADC histogram parameter with the EPE grade system may improve the diagnostic efficacy of EPE.
