title: Detection of prostate cancer in peripheral zone: comparison of MR diffusion tensor imaging, quantitative dynamic contrast-enhanced MRI, and the two techniques combined at 3.0 T.
abstract: BACKGROUND
  Previous studies have shown that the diagnostic accuracy for prostate cancer improved with diffusion tensor imaging (DTI) or quantitative dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) only. However, the efficacy of combined DTI and quantitative DCE-MRI in detecting prostate cancer at 3.0 T is still indeterminate.
  
  
  OBJECTIVE
  To investigate the utility of diffusion tensor imaging (DTI), quantitative DCE-MRI, and the two techniques combined at 3.0 T in detecting prostate cancer of the peripheral zone (PZ).
  
  
  METHODS
  DTI and DCE-MRI of 33 patients was acquired prior to prostate biopsy. Regions of interest (ROIs) were drawn according to biopsy zones which were apex, mid-gland, and base on each side of the PZ. Apparent diffusion coefficient (ADC), fractional anisotropy (FA), volume transfer constant (K(trans)), and rate constant (kep) values of cancerous sextants and non-cancerous sextants in PZ were calculated. Logistic regression models were generated for DTI, DCE-MRI, and DTI + DCE-MRI. Receiver-operating characteristic (ROC) curves were used to compare the ability of these models to differentiate cancerous sextants from non-cancerous sextants of PZ.
  
  
  RESULTS
  There were significant differences in the ADC, FA, K(trans), and kep values between cancerous sextants and non-cancerous sextants in PZ (P < 0.0001, P < 0.0001, P < 0.0001, and P < 0.0001, respectively). The area under curve (AUC) for DTI + DCE-MRI was significantly greater than that for either DTI (0.93 vs. 0.86, P = 0.0017) or DCE-MRI (0.93 vs. 0.84, P = 0.0034) alone.
  
  
  CONCLUSIONS
  The combination of DTI and quantitative DCE-MRI has better diagnostic performance in detecting prostate cancer of the PZ than either technique alone.
authors.affiliation: Department of Radiology, Beijing Hospital of the Ministry of Health, Beijing, China.
authors.forename: Chunmei
authors.initials: C
authors.lastname: Li
authors.forename: Min
authors.initials: M
authors.lastname: Chen
authors.forename: Saying
authors.initials: S
authors.lastname: Li
authors.forename: Xuna
authors.initials: X
authors.lastname: Zhao
authors.forename: Chen
authors.initials: C
authors.lastname: Zhang
authors.forename: Xiaojie
authors.initials: X
authors.lastname: Luo
authors.forename: Cheng
authors.initials: C
authors.lastname: Zhou
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D056324:Diffusion Tensor Imaging; D019786:Gadolinium DTPA; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA
keywords: Diffusion tensor imaging; dynamic contrast-enhanced MRI; prostate cancer