Zhang Li, Li Longchao, Zhe Xia, Tang Min, Lei Xiaoyan, Zhang Jing, Duan Xianglong
Department of MRI, Shaanxi Provincial People's Hospital, 256 Youyi Road, Xi'an, Shaanxi, 710000, China.
Institute of Medical Research Northwestern, Polytechnical University, 127 Youyi Road, Xi'an, Shaanxi, 710000, China.
BMC Cancer. 2025 Jul 30;25(1):1249. doi: 10.1186/s12885-025-14610-1.
The goal of this study was to assess whether combining amide proton transfer (APT)-weighted MRI with the Prostate Imaging Reporting and Data System scoring system version 2.1 (PI-RADS V2.1) could increase diagnostic accuracy compared to PI-RADS V2.1 alone in predicting clinically significant prostate cancer (csPCa).
The present study retrospectively analyzed data from patients who underwent prostate magnetic resonance imaging(MRI) examinations from July 2022 to August 2023. All patients underwent T2-weighted imaging (T2WI), amide proton transfer (APT), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) MRI. Two radiologists independently examined the images. The independent samples t test or the Wilcoxon rank sum test was employed to investigate the statistical variance in the demographic and APT parameters of the two groups. We utilized receiver operating characteristic (ROC) curve analysis to assess the diagnostic accuracy of PI-RADS V2.1 and the combination model (APT-weighted signal values and PI-RADS V2.1). The comparison of the area under the curve (AUC)s were conducted using the Delong method.
A total of 289 patients were eventually included in this study; 102 had csPCa, and 187 had either benign lesions or clinically insignificant prostate cancer (cisPCa). The APTmean, APTmax, and APTmin values were significantly different between the two groups in both the peripheral zone (PZ) and transition zone (TZ). The combined models were significantly more effective than the use of PI-RADS V2.1 alone for the whole gland and PZ, with areas under the curve (AUC)s of 0.874–0.883 compared to 0.803 and 0.885 compared to 0.798, respectively ( < 0.05). However, there was no substantial improvement in diagnostic accuracy when APT-weighted signal values were incorporated into PI-RADS V2.1 for the TZ, as the AUC increased from 0.791 to 0.865, with a value of 0.202.
By incorporating APT-weighted signal values with PI-RADS V2.1, there was a notable improvement in the diagnostic accuracy of csPCa detection in both the whole gland and the PZ compared to PI-RADS V2.1 alone. However, there was no significant enhancement in terms of csPCa in TZ.
The online version contains supplementary material available at 10.1186/s12885-025-14610-1.
本研究的目的是评估将酰胺质子转移（APT）加权磁共振成像（MRI）与前列腺影像报告和数据系统评分系统第2.1版（PI-RADS V2.1）相结合，与单独使用PI-RADS V2.1相比，在预测临床显著前列腺癌（csPCa）时是否能提高诊断准确性。
本研究回顾性分析了2022年7月至2023年8月接受前列腺磁共振成像（MRI）检查的患者数据。所有患者均接受了T2加权成像（T2WI）、酰胺质子转移（APT）、扩散加权成像（DWI）和动态对比增强（DCE）MRI检查。两名放射科医生独立检查图像。采用独立样本t检验或Wilcoxon秩和检验来研究两组在人口统计学和APT参数方面的统计差异。我们利用受试者操作特征（ROC）曲线分析来评估PI-RADS V2.1和联合模型（APT加权信号值和PI-RADS V2.1）的诊断准确性。使用Delong方法对曲线下面积（AUC）进行比较。
本研究最终纳入了289例患者；其中102例患有csPCa，187例患有良性病变或临床意义不显著的前列腺癌（cisPCa）。两组在外周带（PZ）和移行带（TZ）的APT均值、APT最大值和APT最小值均有显著差异。联合模型在整个腺体和PZ的诊断效果明显优于单独使用PI-RADS V2.1，曲线下面积（AUC）分别为0.874 - 0.883和0.885，而单独使用PI-RADS V2.1时分别为0.803和0.798（P < 0.05）。然而，当将APT加权信号值纳入PI-RADS V2.1用于TZ时，诊断准确性没有实质性提高，因为AUC从0.791增加到0.865，P值为0.202。
将APT加权信号值与PI-RADS V2.1相结合，与单独使用PI-RADS V2.1相比，在整个腺体和PZ中检测csPCa的诊断准确性有显著提高。然而，在TZ中，对于csPCa而言没有显著增强。
在线版本包含可在10.1186/s12885-025-14610-1获取的补充材料。
