目的 3T 磁共振成像（MRI）中超高 b 值扩散加权成像（DWI）的表观扩散系数（ADC）图的数值可能是前列腺癌的一种非侵入性特异性生物标志物。

Objective Value of the Apparent Diffusion Coefficient (ADC) Map from Ultrahigh b-value Diffusion-weighted Imaging (DWI) in 3T MRI could be a Non-invasive Specific Biomarker for Prostate Cancer.

作者信息

Zhang Kun, Zhang Chen, Chen Zhengming, Zhang Yun, Dong Zhe, Hu Yingying, Wang Meifeng, Fu Yonggui, Ye Huiyi, Shen Yanguang

机构信息

Department of Radiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China.

Department of Radiology, Chinese PLA General Hospital, Beijing, China.

出版信息

Curr Med Imaging. 2023 Jul 18. doi: 10.2174/1573405620666230718141917.

DOI:10.2174/1573405620666230718141917

PMID:37464833

Abstract

OBJECTIVE

This article aims to explore the ADC value of ultrahigh b-value DWI and the diagnostic cutoff point in prostate cancer.

METHODS

A total of 78 patients were included in this study. T2 weighted imaging (T2WI), conventional diffusion-weighted imaging (DWI) (1000 s/mm2), and DWI with ultrahigh b-values of 2000 s/mm2 and 3000 s/mm2 were performed in each patient. With reference biopsy as the gold standard, the apparent diffusion coefficient (ADC)s of each b-value DWI image were analyzed. According to different b-value receiver operating characteristic (ROC) curves, the ADC diagnostic cutoff point for prostate cancer was determined.

RESULTS

A total of 154 lesions were identified as prostate cancer. The ADC values for conventional DWI and ultrahigh b-value DWI with 2000 s/mm2 and 3000 s/mm2 were 1.097×10-3 mm2/s (1.040-1.153), 0.809×10-3 mm2/s (0.766-0.851) and 0.622×10-3 mm2/s (0.591-0.652), respectively, in the peripheral zone and 1.085×10-3 mm2/s (1.022-1.147), 0.815×10-3 mm2/s (0.770-0.861) and 0.651×10-3 mm2/s (0.617-0.685) in the transition zone. The area under the curve (AUC)s of the ADC values from ultrahigh b-value DWI (2000 s/mm2 and 3000 s/mm2) were 0.824 and 0.852 in the peripheral zone and 0.905 for the ADC values from ultrahigh b-value DWI (3000 s/mm2) in the transition zone. In the peripheral zone, the ADC diagnostic cutoff values for prostate cancer were 0.75×10-3 mm2/s and 0.685×10-3 mm2/s in DWI at 2000 s/mm2 and 3000 s/mm2, respectively, and the diagnosis of transition zone cancer was 0.8×10-3 mm2/s and 0.634×10-3 mm2/s, respectively.

CONCLUSION

The ADC values from ultrahigh b-value DWI demonstrated better consistency and diagnostic efficacy in the diagnosis of prostate cancer.

摘要

目的

本文旨在探讨超高b值扩散加权成像（DWI）的表观扩散系数（ADC）值及前列腺癌的诊断界值。

方法

本研究共纳入78例患者。对每位患者均进行了T2加权成像（T2WI）、常规扩散加权成像（DWI，b值为1000 s/mm²）以及b值为2000 s/mm²和3000 s/mm²的超高b值DWI检查。以参考活检作为金标准，分析各b值DWI图像的表观扩散系数（ADC）。根据不同b值的受试者操作特征（ROC）曲线，确定前列腺癌的ADC诊断界值。

结果

共识别出154个前列腺癌病灶。在外周区，常规DWI以及b值为2000 s/mm²和3000 s/mm²的超高b值DWI的ADC值分别为1.097×10⁻³ mm²/s（1.040 - 1.153）、0.809×10⁻³ mm²/s（0.766 - 0.851）和0.622×10⁻³ mm²/s（0.591 - 0.652）；在移行区，相应的ADC值分别为1.085×10⁻³ mm²/s（1.022 - 1.147）、0.815×10⁻³ mm²/s（0.770 - 0.861）和0.651×10⁻³ mm²/s（0.617 - 0.685）。外周区b值为2000 s/mm²和3000 s/mm²的超高b值DWI的ADC值曲线下面积（AUC）分别为0.824和0.852，移行区b值为3000 s/mm²的超高b值DWI的ADC值AUC为0.905。在外周区，b值为2000 s/mm²和3000 s/mm²的DWI诊断前列腺癌的ADC界值分别为0.75×10⁻³ mm²/s和0.685×10⁻³ mm²/s，移行区癌的诊断界值分别为分别为0.8×10⁻³ mm²/s和0.634×10⁻³ mm²/s。