Li Chunmei, Chen Min, Wan Ben, Yu Jingying, Liu Ming, Zhang Wei, Wang Jianye
1 Department of Radiology, Beijing Hospital, National Center of Gerontology, Beijing, PR China.
2 Department of Urology, Beijing Hospital, National Center of Gerontology, Beijing, PR China.
Acta Radiol. 2018 Nov;59(11):1395-1402. doi: 10.1177/0284185118760961. Epub 2018 Feb 27.
Background Although several studies have been reported on evaluating the performance of Gaussian and different non-Gaussian diffusion models on prostate cancer, few studies have been reported on the comparison of different models on differential diagnosis for prostate cancer. Purpose To compare the utility of various metrics derived from monoexponential model (MEM), biexponential model (BEM), stretched-exponential model (SEM) based diffusion-weighted imaging (DWI) and diffusion kurtosis imaging (DKI) in the differential diagnosis of prostate cancer. Material and Methods Thirty-three patients underwent magnetic resonance imaging (MRI) examination. Multi-b value and multi-direction DWIs were performed. In-bore MR-guided biopsy was performed. Apparent diffusion coefficient (ADC), pure molecular diffusion (ADC), pseudo-diffusion coefficient (ADC), perfusion fraction (f), water molecular diffusion heterogeneity index (α), distributed diffusion coefficient (DDC), non-Gaussian diffusion coefficient (MD), and mean kurtosis (MK) values were calculated and compared between cancerous and non-cancerous groups. Receiver operating characteristic (ROC) analysis was performed for all parameters and models. Results ADC, ADC, DDC, and MD values were significantly lower while MK value was significantly higher in prostate cancer than those of prostatitis and benign prostatic hyperplasia. ADC, ADC, DDC, MD, and MK could discriminate between tumor and non-tumorous lesions (area under the curve, 0.856, 0.835, 0.866, 0.918, and 0.937, respectively). MK was superior to ADC in the discrimination of prostate cancer. DKI was superior to MEM in the discrimination of prostate cancer. Conclusions Parameters derived from both Gaussian and non-Gaussian models could characterize prostate cancer. DKI may be advantageous than DWI for detection of prostate cancer.
尽管已有多项研究报道了评估高斯模型和不同非高斯扩散模型在前列腺癌中的性能，但关于不同模型在前列腺癌鉴别诊断方面的比较研究报道较少。目的：比较基于单指数模型（MEM）、双指数模型（BEM）、拉伸指数模型（SEM）的扩散加权成像（DWI）和扩散峰度成像（DKI）得出的各种指标在前列腺癌鉴别诊断中的效用。材料与方法：33例患者接受了磁共振成像（MRI）检查。进行了多b值和多方向DWI检查。在磁共振引导下进行了穿刺活检。计算并比较了癌灶组和非癌灶组的表观扩散系数（ADC）、纯分子扩散系数（ADC）、伪扩散系数（ADC）、灌注分数（f）、水分子扩散异质性指数（α）、分布扩散系数（DDC）、非高斯扩散系数（MD）和平均峰度（MK）值。对所有参数和模型进行了受试者操作特征（ROC）分析。结果：前列腺癌的ADC、ADC、DDC和MD值显著低于前列腺炎和良性前列腺增生患者，而MK值显著高于后者。ADC、ADC、DDC、MD和MK能够区分肿瘤和非肿瘤病变（曲线下面积分别为0.856、0.835、0.866、0.918和0.937）。在鉴别前列腺癌方面，MK优于ADC。在鉴别前列腺癌方面DKI优于MEM结论：高斯模型和非高斯模型得出的参数均可表征前列腺癌。在检测前列腺癌方面，DKI可能比DWI更具优势。
