title: Intravoxel Incoherent Motion (IVIM) Diffusion Weighted Imaging (DWI) in the Periferic Prostate Cancer Detection and Stratification.
abstract: The aim of this study was to compare the Intravoxel Incoherent Motion (IVIM) parameters between healthy Peripheral Zone (PZ), Benign Prostatic Hyperplasia (BPH) and Prostate Cancer (PCa) and compare them to assess whether there was correlation with Gleason Score (GS) grading system. Thirty-one patients with suspect of PCa underwent 1.5T Multi-Parametric Magnetic Resonance Imaging (MP-MRI) with endorectal coil with a protocol including T2WI, DWI using 10 b values (0, 10, 20, 30, 50, 80, 100, 200, 400, 1000 s/mm2) and DCE. Monoexponential and IVIM model fits were used to calculate both apparent diffusion coefficient (ADC) and the following IVIM parameters: molecular diffusion coefficient (D), perfusion-related diffusion coefficient (D*) and perfusion fraction (f). The ADC and D values were significantly lower in the PCa (0.70 ± 0.16 × 10-3mm2/s and 0.88 ± 0.31 × 10-3mm2/s) compared to those found in the PZ (1.22 ± 0.20 × 10-3mm2/s and 1.78 ± 0.34 × 10-3mm2/s) and in the BPH (1.53 ± 0.23 × 10-3mm2/s and 1.11 ± 0.28 × 10-3mm2/s). The D* parameter was significantly increased in the PCa (5.35 ± 5.12 × 10-3mm2/s) compare to the healthy PZ (3.02 ± 2.86 × 10-3mm2/s), instead there was not significantly difference in the PCa compare to the BPH (5.61 ± 6.77 × 10-3mm2/s). The f was statistically lower in the PCa (9.01 ± 5.20%) compared to PZ (10.57 ± 9.30%), but not significantly different between PCa and BPH (9.29 ± 7.29%). The specificity, sensitivity and accuracy of T2WI associated with DWI and IVIM were higher (100, 98 and 99%, respectively) than for T2WI/DWI and IVIM alone (89, 92 and 90%, respectively). Only for ADC was found a statistical difference between low- and intermediate-/high-grade tumors. Adding IVIM to the MP-MRI could increase the diagnostic performance to detect clinically relevant PCa. ADC values have been found to have a rule to discriminate PCa reliably from normal areas and differed significantly in low- and intermediate-/high-grade PCa. In contrast, IVIM parameters were unable to distinguish between the different GS.
authors.affiliation: Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy. filippopesapane@gmail.com.
authors.forename: Filippo
authors.initials: F
authors.lastname: Pesapane
authors.affiliation: Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Patella
authors.affiliation: Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy.
authors.forename: Enrico Maria
authors.initials: EM
authors.lastname: Fumarola
authors.affiliation: Postgraduation School in Radiodiagnostics, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Panella
authors.affiliation: Department of Radiology, Interventional Radiology, Insubria University, Varese, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Ierardi
authors.affiliation: Department of Health Sciences, Diagnostic and Interventional Radiology, San Paolo Hospital, Università degli Studi di Milano, Via A di Rudinì 8, 20142, Milan, Italy.
authors.forename: Giovanni Guido
authors.initials: GG
authors.lastname: Pompili
authors.affiliation: Department of Health Sciences, Diagnostic and Interventional Radiology, San Paolo Hospital, Università degli Studi di Milano, Via A di Rudinì 8, 20142, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Franceschelli
authors.affiliation: Department of Health Sciences, Diagnostic and Interventional Radiology, San Paolo Hospital, Università degli Studi di Milano, Via A di Rudinì 8, 20142, Milan, Italy.
authors.forename: Salvatore Alessio
authors.initials: SA
authors.lastname: Angileri
authors.affiliation: Department of Health Sciences, Diagnostic and Interventional Radiology, San Paolo Hospital, Università degli Studi di Milano, Via A di Rudinì 8, 20142, Milan, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Magenta Biasina
authors.affiliation: Department of Health Sciences, Diagnostic and Interventional Radiology, San Paolo Hospital, Università degli Studi di Milano, Via A di Rudinì 8, 20142, Milan, Italy.
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Carrafiello
mesh_terms: D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging*
keywords: ADC; DWI; IVIM; Multi-parametric magnetic resonance; Perfusion; Perfusion fraction; Prostate Cancer