深医英文文献阅读（05）：比较常规DWI与DKI对前列腺癌的检测、侵袭性评估的诊断效能

Prostate Cancer : Diffusion-weighted MR Imaging for Detection and Assessment of Aggressiveness - Comparison between Conventional and Kurtosis Models

 比较常规DWI与DKI对前列腺癌的检测、侵袭性评估的诊断效能

      Tamada T, Prabhu V, Li J, et al. Radiology, 2017,284(1):100-108.

深圳市人民医院放射科规培医师

文武成     翻译整理

Original Research

Genitourinary Imaging

Prostate Cancer: Diffusion-weighted MR Imaging for Detection and Assessment of Aggressiveness—Comparison between Conventional and Kurtosis Models

Author List

Tsutomu Tamada, MD¹, Vinay Prabhu, MD, MS, Jianhong Li, MD, James S. Babb, PhD, Samir S. Taneja, MD, Andrew B. Rosenkrantz,MD

Additional Information

From the Department of Radiology (T.T., V.P., J.S.B., A.B.R.), Department of Pathology (J.L.), and Division of Urologic Oncology, Department of Urology (S.S.T., A.B.R.), NYU Langone Medical Center, 550 First Ave, New York, NY 10016.
Address correspondence to T.T. (e-mail: [e-mail]).

https:///10.1148/radiol.2017162321

• Abstract
  

Purpose

To compare standard diffusion-weighted (DW) imaging and diffusion kurtosis (DK) imaging for prostate cancer (PC) detection and characterization in a large patient cohort, with attention to the potential added value of DK imaging.

Materials and Methods

This retrospective institutional review board–approved study received a waiver of informed consent. Two hundred eighty-five patients with PC underwent 3.0-T phased-array coil prostate magnetic resonance (MR) imaging, including a DK imaging sequence (b values 0, 500, 1000, 1500, and 2000 sec/mm²) before prostatectomy. Maps of apparent diffusion coefficient (ADC) and diffusional kurtosis(K) were derived by using maximal b values of 1000 and 2000 sec/mm², respectively. Mean ADC and K were obtained from volumes of interest (VOIs) placed on each patient’s dominant tumor and benign prostate tissue. Metrics were compared between benign and malignant tissue, between Gleason score (GS) ≤ 3 + 3 and GS ≥ 3 + 4 tumors, and between GS ≤ 3 + 4 and GS ≥ 4 + 3 tumors by using paired t tests, analysis of variance, receiver operating characteristic (ROC) analysis, and exact tests.

Results

ADC and K showed significant differences for benign versus tumor tissues, GS ≤ 3 + 3 versus GS ≥ 3 + 4 tumors, and GS ≤ 3 + 4 versus GS ≥ 4 + 3 tumors (P < .001="" for="" all).="" adc="">K were highly correlated (r = −0.82; P < .001).="" area="" under="" the="" roc="" curve="" was="" significantly="" higher="">P = .002) for ADC (0.921) than for K (0.902) for benign versus malignant tissue but was similar for GS ≤ 3 + 3 versus GS ≥ 3 + 4 tumors (0.715–0.744) and GS ≤ 3 + 4 versus GS ≥ 4 + 3 tumors (0.694–0.720) (P > .15). ADC and K were concordant for these various outcomes in 80.0%–88.6% of patients; among patients with discordant results, ADC showed better performance than K for GS ≤ 3 + 4 versus GS ≥ 4 + 3 tumors (P = .016) and was similar to K for other outcomes (P > .136).

Conclusion

ADC and K were highly correlated, had similar diagnostic performance, and were concordant for the various outcomes in the large majority of cases. These observations did not show a clear added value of DK imaging compared with standard DW imaging for clinical PC evaluation.

^© RSNA, 2017

FROM：http://pubs./doi/10.1148/radiol.2017162321

 The two metrics were highly correlated,  had  similar diagnostic performance, and  were concordant  for  the  various  outcomes in the large majority of cases.

 ADC  either  performed  similarly  or  outperformed  K  in this study. Our observations do not show clear added value for  DK imaging  compared with conventional  DW imaging  for  clinical  prostate  cancer  evaluation.