title: Differentiation of prostate cancer and stromal hyperplasia in the transition zone with histogram analysis of the apparent diffusion coefficient.
abstract: Background Prostate cancer and stromal hyperplasia (SH) in the transition zone (TZ) are difficult to discriminate by conventional magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI). Purpose To investigate the apparent diffusion coefficient (ADC) of prostate cancer and SH in the TZ with histogram analysis and the ability of ADC metrics to differentiate between these two tissues. Material and Methods Thirty-three cancer and 29 SH lesions in the TZ of 54 patients undergoing preoperative DWI (b-value 0, 1000 s/mm2) were analyzed. All the lesions on the MR images were localized based on histopathologic correlations. The 10th, 25th, and 50th percentiles, and the mean ADC values were calculated for the two tissues and compared. The efficiencies of the 10th, 25th, and 50th ADC percentiles in differentiating the two tissues were compared with that of the mean ADC with receiver operating characteristic (ROC) analysis. Results The 10th, 25th, and 50th percentiles and mean ADC values (×10-3mm2/s) were 0.86 ± 0.15, 0.89 ± 0.16, 0.94 ± 0.16, and 1.03 ± 0.17 in SH and 0.64 ± 0.12, 0.69 ± 0.12, 0.72 ± 0.16, and 0.83 ± 0.15 in TZ cancer, respectively. The parameters were all significantly lower in cancer than SH. The 10th ADC percentile yielded an area under the ROC curve (AUC) of 0.87 for the differentiation of carcinomas from SH, which was higher than the mean ADC (0.80) ( P < 0.05), and the AUCs of the 25th (0.82) and 50th (0.83) percentiles exhibited no differences from those of the mean ADC ( P > 0.05). Conclusion Histogram analysis of ADC values may potentially improve the differentiation of prostate cancer from SH in the TZ.
authors.affiliation: 1 Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, PR China.|2 Department of Oncology, Fudan University Shanghai Medical College, Shanghai, PR China.
authors.forename: Liu
authors.initials: L
authors.lastname: Xiaohang
authors.affiliation: 1 Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, PR China.|2 Department of Oncology, Fudan University Shanghai Medical College, Shanghai, PR China.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Bingni
authors.affiliation: 1 Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, PR China.|2 Department of Oncology, Fudan University Shanghai Medical College, Shanghai, PR China.
authors.forename: Zhou
authors.initials: Z
authors.lastname: Liangping
authors.affiliation: 1 Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai, PR China.|2 Department of Oncology, Fudan University Shanghai Medical College, Shanghai, PR China.
authors.forename: Peng
authors.initials: P
authors.lastname: Weijun
authors.affiliation: 2 Department of Oncology, Fudan University Shanghai Medical College, Shanghai, PR China.|3 Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, PR China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Xiaoqun
authors.affiliation: 4 MR Research, GE healthcare, Shanghai, PR China.
authors.forename: Zhang
authors.initials: Z
authors.lastname: Yong
mesh_terms: D000368:Aged; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D006801:Humans; D006965:Hyperplasia; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000000981:diagnostic imaging; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging* / Q000473:pathology; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017154:Stromal Cells / Q000473:pathology
keywords: Magnetic resonance (MR) diffusion/perfusion; neoplasms – primary; prostate