Comparison on the diagnostic value of 3.0T two-parameter MRI and multi- parameter imaging in benign & malignant prostate neoplasms

doi:10.3969/j.issn.1004-583X.2022.08.009

Abstract

Abstract:

Objective To explore the value of 3.0T bi-parametric magnetic resonance imaging (bp-MRI) of T2WI and DWI in the differential diagnosis of benign prostate disease and prostate neoplasms. Methods The patients receiving transrectal ultrasound-guided transperineal prostate biopsy hospitalized from 2018 to 2020 were retrospectively analyzed, and all cases received pre-operative multi-parameter prostate magnetic resonance imaging (mp-MRI). Two radiologists scored the prostate imaging-reporting and data system version 2 (PI-RADS v2) and measured apparent diffusion coefficient (ADC) value to confirm the presence of prostate cancer based on bp-MRI of T2WI and DWI, and the biopsy and surgical pathology were considered to be gold standards, the accuracy of corresponding diagnosis, consistency between two observers, as well as the accuracy of the ADC value in the diagnosis of benign and malignant prostate neoplasms were counted, and such indices were compared with the serum biomarker PSA. Results A total of 210 cases including 106 cases of prostate cancer and 104 cases of benign prostatic lesions were included in the study. The area under the curve (AUC) for discriminating benign and malignant nodules based on bp-MRI between Doctor 1 and Doctor 2 was 0.821 (P<0.05) and 0.805 (P<0.05) respectively high inter-observer consistency and KAPPA value in 0.812. The accuracy of AUC of mp-MRI in discriminating benign and malignant lesions was 0.806 (P<0.05), and the difference between bp-MRI and mp-MRI in discriminating benign and malignant prostate lesions wasn't statistically significant (P>0.05). The intraclass correlation efficient (ICC) of ADC value measured by two doctors was 0.795 (P<0.01), the mean value was considered to be the final ADC value due to high consistency, and the value of AUC for discriminating benign and malignant nodules based on ADC value was 0.89 (P<0.05), being higher than that of the total prostate specific antigen(TPSA), free prostate specific antigen (FPSA) and FPSA/TPSA(P<0.05). ADC was found to have the optimal cut-off value in 801.4 mm²/s, sensitivity of 87.5% and specificity of 81.6% in discriminating prostate cancer. Conclusion The difference between 3.0Tbp-MRI and mp-MRI in the diagnosis of benign and malignant prostate lesions wasn't statistically significant, the value of 801.4 mm²/s used as ADC threshold makes for discriminating between benign and malignant lesions.Conclusively, bp-MRI is considered to be a preferred choice in cases suffering from contrast agent allergy or renal insufficiency.

Key words: prostate neoplasms, magnetic resonance imaging, apparent diffusion coefficient, diffusion weighted imaging, prostate specific antigen

CLC Number:

R737.25

Zhong Ye, Xu Jun, Liu Chenping, Wu Gang. Comparison on the diagnostic value of 3.0T two-parameter MRI and multi- parameter imaging in benign & malignant prostate neoplasms[J]. Clinical Focus, 2022, 37(8): 723-727.

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URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2022.08.009

https://huicui.hebmu.edu.cn/EN/Y2022/V37/I8/723

Figures/Tables 5

组别	例数	年龄(岁)	TPSA (ng/ml)	FPSA (ng/ml)	FPSA/TPSA
前列腺癌	106	73.8±7.4	18.2(12.9, 85.6)	3.6(1.9, 10.1)	0.14(0.10, 0.22)
良性前列腺病变	104	68.6±8.5	10.9(6.3, 25.4)	2.1(1.3, 5.3)	0.2(0.13, 0.30)
统计值		$t$ =3.328	$Z$ =-3.564	$Z$ =-2.439	$Z$ =-2.153
$P$ 值		0.001	0.001	0.015	0.031

组别	例数	年龄(岁)	TPSA (ng/ml)	FPSA (ng/ml)	FPSA/TPSA
前列腺癌	106	73.8±7.4	18.2(12.9, 85.6)	3.6(1.9, 10.1)	0.14(0.10, 0.22)
良性前列腺病变	104	68.6±8.5	10.9(6.3, 25.4)	2.1(1.3, 5.3)	0.2(0.13, 0.30)
统计值		$t$ =3.328	$Z$ =-3.564	$Z$ =-2.439	$Z$ =-2.153
$P$ 值		0.001	0.001	0.015	0.031

	AUC值	95% $C I$	标准误	$P$ 值
医生1 bp-MRI	0.821	0.736~0.906	0.043	<0.01
医生2 bp-MRI	0.805	0.717~0.893	0.045	<0.01
mp-MRI	0.806	0.721~0.891	0.044	<0.01

	AUC值	95% $C I$	标准误	$P$ 值
医生1 bp-MRI	0.821	0.736~0.906	0.043	<0.01
医生2 bp-MRI	0.805	0.717~0.893	0.045	<0.01
mp-MRI	0.806	0.721~0.891	0.044	<0.01

	PI-RADS v2评分	医生1
	PI-RADS v2评分	1	2	3	4	5	合计
医生2	1	92	0	0	2	0	94
	2	0	6	2	2	2	12
	3	8	0	8	0	0	16
	4	0	0	0	2	0	2
	5	8	0	0	0	78	86
	合计	108	6	10	6	80	210

变量	AUC	标准误	$P$ 值	95% $C I$	最佳截断值	敏感性(%)	特异性(%)
ADC(mm²/s)	0.890	0.039	0.001	0.814~0.966	801.4	81.6	87.5
TPSA(ng/ml)	0.732	0.052	0.001	0.630~0.834	12.6	77.3	57.4
FPSA(ng/ml)	0.644	0.059	0.018	0.529~0.760	1.8	79.5	44.7
FPSA/TPSA	0.631	0.060	0.031	0.514~0.748	0.12	47.7	80.9

变量	AUC	标准误	$P$ 值	95% $C I$	最佳截断值	敏感性(%)	特异性(%)
ADC(mm²/s)	0.890	0.039	0.001	0.814~0.966	801.4	81.6	87.5
TPSA(ng/ml)	0.732	0.052	0.001	0.630~0.834	12.6	77.3	57.4
FPSA(ng/ml)	0.644	0.059	0.018	0.529~0.760	1.8	79.5	44.7
FPSA/TPSA	0.631	0.060	0.031	0.514~0.748	0.12	47.7	80.9

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