Jiang Yuwei, Li Chunmei, Liu Ying, Shi Kaining, Zhang Wei, Liu Ming, Chen Min
Peking University Fifth School of Clinical Medicine, Beijing, China.
Radiology Department, Beijing Hospital, National Center of Gerontology, Beijing, China.
Acta Radiol. 2020 Oct;61(10):1431-1440. doi: 10.1177/0284185120901504. Epub 2020 Feb 2.
There is still little research about histogram analysis of diffusion kurtosis imaging (DKI) using in prostate cancer at present.
To verify the utility of histogram analysis of DKI model in detection and assessment of aggressiveness of prostate cancer, compared with monoexponential model (MEM).
Twenty-three patients were enrolled in this study. For DKI model and MEM, the D, K, and apparent diffusion coefficient (ADC) were obtained by using single-shot echo-planar imaging sequence. The pathologies were confirmed by in-bore magnetic resonance (MR)-guided biopsy. Regions of interest (ROI) were drawn manually in the position where biopsy needle was put. The mean values and histogram parameters in cancer and noncancerous foci were compared using independent-samples T test. Receiver operating characteristic curves were used to investigate the diagnostic efficiency. Spearman's test was used to evaluate the correlation of parameters and Gleason scores.
The mean, 10th, 25th, 50th, 75th, and 90th percentiles of ADC and D were significantly lower in prostate cancer than non-cancerous foci ( < 0.001). The mean, 50th, 75th, and 90th percentiles of K were significantly higher in prostate cancer ( < 0.05). There was no significant difference between the AUCs of two models (0.971 vs. 0.963, > 0.05). With the increasing Gleason scores, the 10th ADC decreased ( = -0.583, = 0.018), but the 90th K increased ( = 0.642, = 0.007).
Histogram analysis of DKI model is feasible for diagnosing and grading prostate cancer, but it has no significant advantage over MEM.
目前关于扩散峰度成像（DKI）直方图分析在前列腺癌中的应用研究仍较少。
与单指数模型（MEM）相比，验证DKI模型直方图分析在前列腺癌检测及侵袭性评估中的效用。
本研究纳入23例患者。对于DKI模型和MEM，采用单次激发回波平面成像序列获取扩散系数（D）、峰度系数（K）和表观扩散系数（ADC）。通过腔内磁共振（MR）引导活检确诊病理情况。在活检针穿刺部位手动绘制感兴趣区（ROI）。采用独立样本t检验比较癌灶和非癌灶的平均值及直方图参数。采用受试者操作特征曲线研究诊断效能。采用Spearman检验评估参数与Gleason评分的相关性。
前列腺癌中ADC和D的平均值、第10、25、50、75和90百分位数均显著低于非癌灶（<0.001）。前列腺癌中K的平均值、第50、75和90百分位数显著更高（<0.05）。两种模型的曲线下面积（AUC）无显著差异（0.971对0.963，>0.05）。随着Gleason评分增加，第10百分位数的ADC降低（= -0.583，= 0.018），但第90百分位数的K增加（= 0.642，= 0.007）。
DKI模型直方图分析对前列腺癌的诊断和分级可行，但与MEM相比无显著优势。
