Zhongwei Chen1, Yingnan Xue1, Zhao Zhang1, Weikang Li1, Min Wen2, Youfan Zhao1, Jiance Li1, Zhiliang Weng3, Qiong Ye4. 1. Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China. 2. Department of Neurosurgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China. 3. Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China. 4. Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, PR China; High Magnetic Field Laboratory, Hefei Institutes of Physical Science, Chinese Academy of Sciences, Hefei, Anhui, PR China. Electronic address: 94301699@qq.com.
Abstract
PURPOSE: To assess the association between intravoxel-incoherent motion diffusion-weighted imaging (IVIM) derived hypoxia and the aggressiveness of prostate cancer (PCa) and to explore its contribution to the risk stratification of PCa. METHODS: Seventy-five peripheral zone (PZ) PCa patients, who underwent multiparametric MRI (mpMRI), were included in this study. Systematic ultrasound guided biopsy was used as reference. IVIM was acquired with 5 b values (b = 0∼750 s/mm2). Apparent diffusion coefficient (ADC), pure tissue diffusion (Ds), volume fraction of pseudo-diffusion (fp), hypoxic fraction (HFDWI), hypoxia score (HSDWI) and relative oxygen saturation(rOSDWI), were calculated and histogram analysis was applied. Groups comparison was performed between low-intermediate-grade group (LG, the International Society of Urological Pathology (ISUP) Gleason Grade (GG) ≤2) and high-grade (HG, ISUP GG ≥ 3) group. The correlation between diffusion parameters and ISUP GG was assessed. Cross-validated Support Vector Machine (SVM) Classification was performed and compared with univariate ROC analysis to explore the risk stratification of PZ PCa. RESULTS: Mean, median, and the 10th percentile of Ds differed significantly between groups (p < 0.05). Several parameters significantly correlated with ISUP grade, and the 10th percentile of Ds showed the strongest correlation (ρ= - 0.284). The prediction model containing IVIM derived hypoxia yielded an area under the receiver operating characteristics curve (AUC) ranging 0.749-0.786 for cross-validation. The AUCs of the SVM modeling were higher than that of any single parameter. CONCLUSION: IVIM derived hypoxia demonstrated significant correlation with the aggressiveness of PCa. It's supplemental to the MRI assessment of PCa with a promising stratification of risk stratification of PZ PCa.
PURPOSE: To assess the association between intravoxel-incoherent motion diffusion-weighted imaging (IVIM) derived hypoxia and the aggressiveness of prostate cancer (PCa) and to explore its contribution to the risk stratification of PCa. METHODS: Seventy-five peripheral zone (PZ) PCapatients, who underwent multiparametric MRI (mpMRI), were included in this study. Systematic ultrasound guided biopsy was used as reference. IVIM was acquired with 5 b values (b = 0∼750 s/mm2). Apparent diffusion coefficient (ADC), pure tissue diffusion (Ds), volume fraction of pseudo-diffusion (fp), hypoxic fraction (HFDWI), hypoxia score (HSDWI) and relative oxygen saturation(rOSDWI), were calculated and histogram analysis was applied. Groups comparison was performed between low-intermediate-grade group (LG, the International Society of Urological Pathology (ISUP) Gleason Grade (GG) ≤2) and high-grade (HG, ISUP GG ≥ 3) group. The correlation between diffusion parameters and ISUP GG was assessed. Cross-validated Support Vector Machine (SVM) Classification was performed and compared with univariate ROC analysis to explore the risk stratification of PZ PCa. RESULTS: Mean, median, and the 10th percentile of Ds differed significantly between groups (p < 0.05). Several parameters significantly correlated with ISUP grade, and the 10th percentile of Ds showed the strongest correlation (ρ= - 0.284). The prediction model containing IVIM derived hypoxia yielded an area under the receiver operating characteristics curve (AUC) ranging 0.749-0.786 for cross-validation. The AUCs of the SVM modeling were higher than that of any single parameter. CONCLUSION: IVIM derived hypoxia demonstrated significant correlation with the aggressiveness of PCa. It's supplemental to the MRI assessment of PCa with a promising stratification of risk stratification of PZ PCa.
Authors: Paul J Keall; Caterina Brighi; Carri Glide-Hurst; Gary Liney; Paul Z Y Liu; Suzanne Lydiard; Chiara Paganelli; Trang Pham; Shanshan Shan; Alison C Tree; Uulke A van der Heide; David E J Waddington; Brendan Whelan Journal: Nat Rev Clin Oncol Date: 2022-04-19 Impact factor: 65.011