3T multiparametric MRI of the prostate: Does intravoxel incoherent motion diffusion imaging have a role in the detection and stratification of prostate cancer in the peripheral zone?

• DOI: 10.1016/j.ejrad.2016.01.006
• Publication Date: 2016-01-19T20:46:46Z
• Authors: Mariacristina Val...; Chiara Zini; Davide Fierro; Francesca Giura; Anna Colarieti; Alessandro Giuliani; Andrea Laghi; Carlo Catalano; Valeria Panebianco
• Keywords: Male; Biopsy; Prostate; 610; Contrast Media; Discriminant Analysis; Prostatic Neoplasms; Middle Aged; Sensitivity and Specificity; 3. Good health; Perfusion; Motion; 03 medical and health sciences; Diffusion Magnetic Resonance Imaging; 0302 clinical medicine; diffusion weighted imaging; Image Processing, Computer-Assisted; gleason score; diffusion weighted imaging; gleason score; intravoxel incoherent motion; Humans; Prospective Studies; Neoplasm Grading; intravoxel incoherent motion

To evaluate the potential added value of the intravoxel incoherent motion model to conventional multiparametric magnetic resonance protocol in order to differentiate between healthy and neoplastic prostate tissue in the peripheral zone.Mono-exponential and bi-exponential fits were used to calculate ADC and IVIM parameters in 53 patients with peripheral zone biopsy proved tumor. Inferential statistics analysis was performed on T2, ADC and IVIM parameters (D, D*, f) comparing healthy and neoplastic tissues. Linear discriminant analysis was performed for the conventional parameters (T2 and ADC), the IVIM parameters (molecular diffusion coefficient (D), perfusion-related diffusion coefficient (D*), and perfusion fraction (f) and the combined T2-weighted imaging/DWI and IVIM parameters (T2, ADC, D, D* and f). A correlation with Gleason scores was achieved.The values of T2, ADC and D were significantly lower in cancerous tissues (2749.82 ± 1324.67 ms, 0.76 ± 0.27 × 10(-3)mm(2)/s and 0.99 ± 0.38 × 10(-3)mm(2)/s respectively) compared to those found in the healthy tissues (3750.70 ± 1735.37 ms, 1.39 ± 0.48 × 10(-3)mm(2)/s and 1.77 ± 0.36 × 10(-3)mm(2)/s respectively); D* parameter was significantly increased in neoplastic compared to healthy tissue (15.56 ± 12.91 × 10(-3)mm(2)/s and 10.25 ± 10.52 × 10(-3)mm(2)/s respectively). The specificity, sensitivity and accuracy of the T2-weighted imaging/DWI and IVIM parameters were 100, 96 and 98%, respectively, compare to 88, 92 and 90% and 96, 92 and 94 for T2-weighted imaging/ADC and IVIM alone.IVIM parameters increase the specificity and sensitivity in the evaluation of peripheral zone prostate cancer. A statistical difference between low grade tumors and high grade tumors has been demostrated in that ADC, D and D* dataset; in particular, D has been found to have the highest significativity.