Sung Y Park1,2, Chan K Kim1,3, Jung J Park1, Byung K Park1. 1. 1 Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan, Seoul, Republic of Korea. 2. 2 Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. 3. 3 Department of Medical Device Management & Research, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea.
Abstract
OBJECTIVE: To investigate the feasibility of exponential apparent diffusion coefficient (eADC) derived from diffusion-weighted imaging (DWI) in evaluating prostate cancers at 3 T. METHODS: 74 consecutive patients with surgically confirmed single peripheral zone (PZ) prostate cancer ≥0.5 cm(3) who underwent pre-operative DWI at 3 T were retrospectively selected. Based on radiological-pathological correlation, eADC and apparent diffusion coefficient (ADC) (×10(-3) mm(2) s(-1)) for the cancers and benign PZ were measured by two independent readers. Tumour eADC or ADC was correlated with Gleason score. Receiver operating characteristic curve analysis was performed to differentiate between Gleason score 6 and 7 or higher, by eADC and ADC. Lesion-to-background contrast ratio was compared between eADC and ADC. RESULTS: Mean tumour eADC (0.48-0.50) and ADC (0.72-0.75) were significantly different from those of benign PZ (eADC, 0.20-0.27; ADC, 1.34-1.66), respectively (p < 0.001). A moderate correlation between tumour eADC or ADC and Gleason score was seen. For differentiating between Gleason score 6 and 7 or higher, eADC (0.818-0.883) showed a similar area under the curve with ADC (0.840-0.889) (p > 0.05). Lesion-to-background contrast ratio of eADC (Reader 1, 2.43; Reader 2, 2.23) was significantly greater than that of ADC (Reader 1, 2.21; Reader 2, 2.12) (p < 0.001). CONCLUSION: The eADC may offer similar diagnostic utility with ADC in the differentiation of the cancer from benign prostate tissue. Moreover, the eADC appears to allow improved tissue contrast. ADVANCES IN KNOWLEDGE: The eADC may be a comparable alternative to ADC for evaluating prostate cancer, with removing T2 shine-through effects from DWI.
OBJECTIVE: To investigate the feasibility of exponential apparent diffusion coefficient (eADC) derived from diffusion-weighted imaging (DWI) in evaluating prostate cancers at 3 T. METHODS: 74 consecutive patients with surgically confirmed single peripheral zone (PZ) prostate cancer ≥0.5 cm(3) who underwent pre-operative DWI at 3 T were retrospectively selected. Based on radiological-pathological correlation, eADC and apparent diffusion coefficient (ADC) (×10(-3) mm(2) s(-1)) for the cancers and benign PZ were measured by two independent readers. TumoureADC or ADC was correlated with Gleason score. Receiver operating characteristic curve analysis was performed to differentiate between Gleason score 6 and 7 or higher, by eADC and ADC. Lesion-to-background contrast ratio was compared between eADC and ADC. RESULTS: Mean tumoureADC (0.48-0.50) and ADC (0.72-0.75) were significantly different from those of benign PZ (eADC, 0.20-0.27; ADC, 1.34-1.66), respectively (p < 0.001). A moderate correlation between tumoureADC or ADC and Gleason score was seen. For differentiating between Gleason score 6 and 7 or higher, eADC (0.818-0.883) showed a similar area under the curve with ADC (0.840-0.889) (p > 0.05). Lesion-to-background contrast ratio of eADC (Reader 1, 2.43; Reader 2, 2.23) was significantly greater than that of ADC (Reader 1, 2.21; Reader 2, 2.12) (p < 0.001). CONCLUSION: The eADC may offer similar diagnostic utility with ADC in the differentiation of the cancer from benign prostate tissue. Moreover, the eADC appears to allow improved tissue contrast. ADVANCES IN KNOWLEDGE: The eADC may be a comparable alternative to ADC for evaluating prostate cancer, with removing T2 shine-through effects from DWI.
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