Yang Xuezhen, Shan Lianqiang, Cao Haiming, Jiang Xu, Ma Xueping
Department of Urology.
Department of Radiology, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China.
Medicine (Baltimore). 2020 Nov 25;99(48):e23134. doi: 10.1097/MD.0000000000023134.
To investigate the value of the 1.5T magnetic resonance imaging (MRI) apparent diffusion coefficient (ADC) and the prostate imaging reporting and data system (PI-RADS) score in prostate cancer (PCa) screening.Forty PCa patients diagnosed by pathology from December 2014 to September 2018 were recruited as the PCa group; 60 patients with benign prostatic hyperplasia (BPH) were recruited as the benign group. Patients from both groups underwent 1.5T MRI scanning. The prostate ADC values, exponential apparent diffusion coefficient (eADC) values, and PI-RADS scores of patients from the 2 groups were compared. The different methods for PCa diagnosis were compared.The ADC values of patients in the PCa group were significantly lower than those in the benign group, whereas the eADC values of patients were significantly higher than those in the benign group, with statistically significant differences (P < .05). The differences in the PI-RADS scores of patients from the 2 groups were statistically significant (P < .05). Receiver Operating Characteristic (ROC) curve results showed that the ADC value combined with the PI-RADS score was superior to the ADC value or the PI-RADS score alone in sensitivity, specificity, and Youden index for PCa diagnosis. By comparing the area under the curve (AUC) of each ROC curve from the different diagnostic methods, the combination of ADC value and PI-RADS score showed the largest area.The ADC value from 1.5T MRI combined with the PI-RADS score could be used as the standard for PCa screening, which would effectively improve screening for PCa and be valuable for clinical applications.
探讨1.5T磁共振成像（MRI）表观扩散系数（ADC）及前列腺影像报告和数据系统（PI-RADS）评分在前列腺癌（PCa）筛查中的价值。选取2014年12月至2018年9月间经病理诊断的40例PCa患者作为PCa组；选取60例良性前列腺增生（BPH）患者作为良性组。两组患者均接受1.5T MRI扫描。比较两组患者的前列腺ADC值、指数表观扩散系数（eADC）值及PI-RADS评分。比较不同PCa诊断方法。PCa组患者的ADC值显著低于良性组，而eADC值显著高于良性组，差异有统计学意义（P<0.05）。两组患者PI-RADS评分差异有统计学意义（P<0.05）。受试者操作特征（ROC）曲线结果显示，ADC值联合PI-RADS评分在PCa诊断的敏感性、特异性及约登指数方面优于单独的ADC值或PI-RADS评分。通过比较不同诊断方法各ROC曲线下面积（AUC），ADC值与PI-RADS评分联合显示的面积最大。1.5T MRI的ADC值联合PI-RADS评分可作为PCa筛查标准，能有效提高PCa筛查效果，具有临床应用价值。
