Lou Xiongbo
Department of Radiology, General Hospital of Traditional Chinese Medicine Hospital of Keqiao District, Shaoxing, Zhejiang, 312030, People's Republic of China.
Cancer Manag Res. 2025 Aug 27;17:1803-1812. doi: 10.2147/CMAR.S543435. eCollection 2025.
To evaluate the diagnostic efficacy and clinical relevance of multiparametric MRI (mpMRI) in detecting prostate cancer (PCA).
This retrospective study analyzed 64 patients with suspected PCA who underwent MRI and were pathologically diagnosed with either PCA (n=33) or benign prostatic lesions (BPL, n=31). Imaging characteristics were assessed using T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced MRI (DCE-MRI). DWI signal intensities at b=50 and b=800s/mm² and apparent diffusion coefficient (ADC) values were compared. Perfusion parameters, including Ktrans, Ve, and Kep, were also analyzed. Spearman correlation assessed associations between imaging parameters and PCA occurrence. Receiver operating characteristic (ROC) curves evaluated the diagnostic performance of each sequence and their combination.
PCA lesions showed hypointensity on T2WI, hyperintensity on DWI, and type II/III curves on DCE-MRI. Signal intensities at b=50 and b=800s/mm² and ADC values were significantly lower in PCA than in BPL (P < 0.05), whereas Ktrans, Ve, and Kep were significantly higher (P < 0.05). Spearman analysis showed negative correlations between PCA occurrence and b=50, b=800 signal intensities and ADC (r = -0.547, -0.529, -0.601), and positive correlations with Ktrans, Ve, and Kep (r = 0.516, 0.538, 0.552; all P < 0.05). ROC analysis revealed AUCs of 0.834 (T2WI), 0.819 (DWI), 0.696 (DCE-MRI), and 0.902 (combined T2WI+DWI), with the combined approach yielding the highest diagnostic accuracy.
mpMRI parameters including DWI signal intensity, ADC, and DCE-MRI perfusion values are significantly associated with PCA. Combined application of T2WI and DWI improves diagnostic accuracy and may offer greater clinical value than individual sequences.
评估多参数磁共振成像（mpMRI）在检测前列腺癌（PCA）中的诊断效能及临床相关性。
本回顾性研究分析了64例疑似PCA且接受了MRI检查并经病理诊断为PCA（n = 33）或良性前列腺病变（BPL，n = 31）的患者。使用T2加权成像（T2WI）、扩散加权成像（DWI）和动态对比增强MRI（DCE-MRI）评估成像特征。比较了b = 50和b = 800 s/mm²时的DWI信号强度及表观扩散系数（ADC）值。还分析了包括Ktrans、Ve和Kep在内的灌注参数。Spearman相关性分析评估成像参数与PCA发生之间的关联。受试者操作特征（ROC）曲线评估了每个序列及其组合的诊断性能。
PCA病变在T2WI上呈低信号，在DWI上呈高信号，在DCE-MRI上呈II/III型曲线。PCA中b = 50和b = 800 s/mm²时的信号强度及ADC值显著低于BPL（P < 0.05），而Ktrans、Ve和Kep则显著更高（P < 0.05）。Spearman分析显示PCA发生与b = 50、b = 800信号强度及ADC呈负相关（r = -0.547、-0.529、-0.601），与Ktrans、Ve和Kep呈正相关（r = 0.516、0.538、0.552；均P < 0.05）。ROC分析显示T2WI的曲线下面积（AUC）为0.834，DWI为0.819，DCE-MRI为0.696，联合T2WI + DWI为0.902，联合方法具有最高的诊断准确性。
包括DWI信号强度、ADC及DCE-MRI灌注值在内的mpMRI参数与PCA显著相关。T2WI和DWI的联合应用提高了诊断准确性，可能比单个序列具有更大的临床价值。
