title: Differentiating Transition Zone Cancers From Benign Prostatic Hyperplasia by Quantitative Multiparametric Magnetic Resonance Imaging.
abstract: OBJECTIVE
  The aim of this study was to evaluate the value of quantitative diffusion and perfusion parameters to aid in discriminating between transition zone carcinomas and benign prostatic hyperplasia (BPH).
  
  
  METHODS
  Twenty-four transition zone cancers and BPH nodules were contoured on T2-weighted magnetic resonance imaging (MRI), apparent diffusion coefficient (ADC) maps, and raw dynamic contrast-enhanced (DCE) MRI. Benign prostatic hyperplasia nodules were then stratified into 2 groups based on the presence or absence of a capsule. Apparent diffusion coefficient values, per-voxel Ktrans, kep, vp, and ve were all compared across all groups.
  
  
  RESULTS
  Average ADCs (×10 mm/s) were 1019.22, 1338.11, and 1272.46 for cancer, encapsulated BPH, and nonencapsulated BPH, respectively. Both subgroups of BPH were found to be significantly different than that of cancer (P < 0.05). No individual DCE-MRI parameter was significantly different between cancer and either BPH group. The area under the curve for ADC alone was 0.83, and no individual DCE imaging parameter improved the area under the curve of ADC.
  
  
  CONCLUSIONS
  Apparent diffusion coefficient may play a role in distinguishing TZ cancers from non-encapsulated BPH nodules that closely resemble cancer.
authors.affiliation: From the *Molecular Imaging Program, National Cancer Institute, National Institutes of Health, Bethesda, MD; †iCAD, Inc, Nashua, NH; ‡Division of Cancer Treatment and Diagnosis, Biometric Research Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD; §Imaging Physics, SAIC Frederick, Inc, National Cancer Institute-Frederick, Frederick, MD; and ∥Laboratory of Pathology, ¶Center for Interventional Oncology, and #Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD.
authors.forename: Osama
authors.initials: O
authors.lastname: Elbuluk
authors.forename: Naira
authors.initials: N
authors.lastname: Muradyan
authors.forename: Joanna
authors.initials: J
authors.lastname: Shih
authors.forename: Marcelino
authors.initials: M
authors.lastname: Bernardo
authors.forename: Sandeep
authors.initials: S
authors.lastname: Sankineni
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Merino
authors.forename: Bradford J
authors.initials: BJ
authors.lastname: Wood
authors.forename: Peter A
authors.initials: PA
authors.lastname: Pinto
authors.forename: Peter L
authors.initials: PL
authors.lastname: Choyke
authors.forename: Baris
authors.initials: B
authors.lastname: Turkbey
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology; D011470:Prostatic Hyperplasia / Q000473:pathology*; D011471:Prostatic Neoplasms / Q000473:pathology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity