当前位置： SCI文献检索 > INVESTIGATIVE RADIOLOGY期刊下所有文献 > Measured Multipoint Ultra-High b-Value Diffusion MRI in the Assessment of MRI-Detected Prostate Lesions.

Measured Multipoint Ultra-High b-Value Diffusion MRI in the Assessment of MRI-Detected Prostate Lesions.

Abstract：

OBJECTIVES:The aim of this study was to assess quantitative ultra-high b-value (UHB) diffusion magnetic resonance imaging (MRI)-derived parameters in comparison to standard clinical apparent diffusion coefficient (SD-ADC-2b-1000, SD-ADC-2b-1500) for the prediction of clinically significant prostate cancer, defined as Gleason Grade Group greater than or equal to 2. MATERIALS AND METHODS:Seventy-three patients who underwent 3-T prostate MRI with diffusion-weighted imaging acquired at b = 50/500/1000/1500s/mm2 and b = 100/500/1000/1500/2250/3000/4000 s/mm2 were included. Magnetic resonance lesions were segmented manually on individual sequences, then matched to targeted transrectal ultrasonography/MRI fusion biopsies. Monoexponential 2-point and multipoint fits of standard diffusion and of UHB diffusion were calculated with incremental b-values. Furthermore, a kurtosis fit with parameters Dapp and Kapp with incremental b-values was obtained. Each parameter was examined for prediction of clinically significant prostate cancer using bootstrapped receiver operating characteristics and decision curve analysis. Parameter models were compared using Vuong test. RESULTS:Fifty of 73 men (age, 66 years [interquartile range, 61-72]; prostate-specific antigen, 6.6 ng/mL [interquartile range, 5-9.7]) had 64 MRI-detected lesions. The performance of SD-ADC-2b-1000 (area under the curve, 0.82) and SD-ADC-2b-1500 (area under the curve, 0.82) was not statistically different (P = 0.99), with SD-ADC-2b-1500 selected as reference. Compared with the reference model, none of the 19 tested logistic regression parameter models including multipoint and 2-point UHB-ADC, Dapp, and Kapp with incremental b-values of up to 4000 s/mm2 outperformed SD-ADC-2b-1500 (all P's > 0.05). Decision curve analysis confirmed these results indicating no higher net benefit for UHB parameters in comparison to SD-ADC-2b-1500 in the clinically important range from 3% to 20% of cancer threshold probability. Net reduction analysis showed no reduction of MR lesions requiring biopsy. CONCLUSIONS:Despite evaluation of a large b-value range and inclusion of 2-point, multipoint, and kurtosis models, none of the parameters provided better predictive performance than standard 2-point ADC measurements using b-values 50/1000 or 50/1500. Our results suggest that most of the diagnostic benefits available in diffusion MRI are already represented in an ADC composed of one low and one 1000 to 1500 s/mm2 b-value.

journal_name

Invest Radiol

journal_title

Investigative radiology

authors

Tavakoli AA,Kuder TA,Tichy D,Radtke JP,Görtz M,Schütz V,Stenzinger A,Hohenfellner M,Schlemmer HP,Bonekamp D

doi

10.1097/RLI.0000000000000712

subject

Has Abstract

pub_date

2021-02-01 00:00:00

pages

94-102

issue

eissn

0020-9996

issn

1536-0210

pii

00004424-202102000-00004

journal_volume

pub_type

杂志文章

在线工具

Measured Multipoint Ultra-High b-Value Diffusion MRI in the Assessment of MRI-Detected Prostate Lesions.