Tamura Chiharu, Shinmoto Hiroshi, Soga Shigeyoshi, Okamura Teppei, Sato Hiroki, Okuaki Tomoyuki, Pang Yuxi, Kosuda Shigeru, Kaji Tatsumi
Department of Radiology, National Defense Medical College, Saitama, Japan.
J Magn Reson Imaging. 2014 Sep;40(3):723-9. doi: 10.1002/jmri.24379. Epub 2013 Oct 31.
To evaluate the differences in parameters of diffusion kurtosis imaging (DKI) between prostate cancer, benign prostatic hyperplasia (BPH), and benign peripheral zone (PZ).
Twenty-four foci of prostate cancer, 41 BPH nodules (14 stromal and 27 nonstromal hyperplasia), and 20 benign PZ from 20 patients who underwent radical prostatectomy were investigated. Diffusion-weighted imaging (DWI) was performed using 11 b-values (0-1500 s/mm(2) ). DKI model relates DWI signal decay to parameters that reflect non-Gaussian diffusion coefficient (D) and deviations from normal distribution (K). A mixed model analysis of variance and receiver operating characteristic (ROC) analyses were performed to assess the statistical significance of the metrics of DKI and apparent diffusion coefficient (ADC).
K was significantly higher in prostate cancer and stromal BPH than in benign PZ (1.19 ± 0.24 and 0.99 ± 0.28 versus 0.63 ± 0.23, P < 0.001 and P < 0.001, respectively). K showed a trend toward higher levels in prostate cancer than in stromal BPH (1.19 ± 0.24 versus 0.99 ± 0.28, P = 0.051). On the ROC analyses, a significant difference in area under the curve was not observed between K and ADC, however, K showed the highest sensitivity among three parameters.
DKI may contribute to the imaging diagnosis of prostate cancer, especially in the differential diagnosis of prostate cancer and BPH.
评估前列腺癌、良性前列腺增生（BPH）和良性外周带（PZ）之间扩散峰度成像（DKI）参数的差异。
对20例行根治性前列腺切除术患者的24个前列腺癌病灶、41个BPH结节（14个基质增生和27个非基质增生）及20个良性PZ进行研究。使用11个b值（0 - 1500 s/mm²）进行扩散加权成像（DWI）。DKI模型将DWI信号衰减与反映非高斯扩散系数（D）和偏离正态分布（K）的参数相关联。进行方差混合模型分析和受试者操作特征（ROC）分析，以评估DKI指标和表观扩散系数（ADC）的统计学意义。
前列腺癌和基质性BPH中的K值显著高于良性PZ（分别为1.19±0.24和0.99±0.28对比0.63±0.23，P < 0.001和P < 0.001）。K值在前列腺癌中呈现出高于基质性BPH的趋势（1.19±0.24对比0.99±0.28，P = 0.051）。在ROC分析中，未观察到K值和ADC值曲线下面积的显著差异，然而，K值在三个参数中显示出最高的敏感性。
DKI可能有助于前列腺癌的影像诊断，尤其是在前列腺癌与BPH的鉴别诊断中。
