Xiaohang Liu, Bingni Zhou, Liangping Zhou, Weijun Peng, Xiaoqun Yang, Yong Zhang
1 Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, PR China.
2 Department of Oncology, Fudan University Shanghai Medical College, Shanghai, PR China.
Acta Radiol. 2017 Dec;58(12):1528-1534. doi: 10.1177/0284185117698861. Epub 2017 Mar 12.
Background Prostate cancer and stromal hyperplasia (SH) in the transition zone (TZ) are difficult to discriminate by conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI). Purpose To investigate the apparent diffusion coefficient (ADC) of prostate cancer and SH in the TZ with histogram analysis and the ability of ADC metrics to differentiate between these two tissues. Material and Methods Thirty-three cancer and 29 SH lesions in the TZ of 54 patients undergoing preoperative DWI (b-value 0, 1000 s/mm) were analyzed. All the lesions on the MR images were localized based on histopathologic correlations. The 10th, 25th, and 50th percentiles, and the mean ADC values were calculated for the two tissues and compared. The efficiencies of the 10th, 25th, and 50th ADC percentiles in differentiating the two tissues were compared with that of the mean ADC with receiver operating characteristic (ROC) analysis. Results The 10th, 25th, and 50th percentiles and mean ADC values (×10 mm/s) were 0.86 ± 0.15, 0.89 ± 0.16, 0.94 ± 0.16, and 1.03 ± 0.17 in SH and 0.64 ± 0.12, 0.69 ± 0.12, 0.72 ± 0.16, and 0.83 ± 0.15 in TZ cancer, respectively. The parameters were all significantly lower in cancer than SH. The 10th ADC percentile yielded an area under the ROC curve (AUC) of 0.87 for the differentiation of carcinomas from SH, which was higher than the mean ADC (0.80) ( P < 0.05), and the AUCs of the 25th (0.82) and 50th (0.83) percentiles exhibited no differences from those of the mean ADC ( P > 0.05). Conclusion Histogram analysis of ADC values may potentially improve the differentiation of prostate cancer from SH in the TZ.
前列腺移行带（TZ）中的前列腺癌与基质增生（SH）难以通过传统磁共振成像（MRI）和扩散加权成像（DWI）进行鉴别。目的：通过直方图分析研究前列腺移行带中前列腺癌与SH的表观扩散系数（ADC），以及ADC指标区分这两种组织的能力。材料与方法：对54例接受术前DWI（b值为0、1000 s/mm²）患者的TZ中的33个癌灶和29个SH病灶进行分析。基于组织病理学相关性对MR图像上的所有病灶进行定位。计算两种组织的第10、25和50百分位数以及平均ADC值并进行比较。通过受试者操作特征（ROC）分析，将第10、25和50 ADC百分位数区分这两种组织的效能与平均ADC的效能进行比较。结果：SH的第10、25和50百分位数以及平均ADC值（×10⁻³mm²/s）分别为0.86±0.15、0.89±0.16、0.94±0.16和1.03±0.17，TZ癌的分别为0.64±0.12、0.69±0.12、0.72±0.16和0.83±0.15。癌灶的这些参数均显著低于SH。第10 ADC百分位数在区分癌与SH时的ROC曲线下面积（AUC）为0.87，高于平均ADC的AUC（0.80）（P<0.05），第25（0.82）和50（0.83）百分位数的AUC与平均ADC的AUC无差异（P>0.05）。结论：ADC值的直方图分析可能有助于提高前列腺移行带中前列腺癌与SH的鉴别能力。
