Comparison of diagnostic performance between diffusion kurtosis imaging parameters and mono-exponential ADC for determin
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Comparison of diagnostic performance between diffusion kurtosis imaging parameters and mono‑exponential ADC for determination of clinically significant cancer in patients with prostate cancer Hyungin Park1 · Seung Ho Kim1 · Yedaun Lee1 · Jung Hee Son1 Received: 12 July 2020 / Revised: 9 September 2020 / Accepted: 10 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose To compare the diagnostic performance between diffusion kurtosis imaging (DKI) parameters and mono-exponential apparent diffusion coefficient (ADC) for determination of clinically significant cancer (CSC, Gleason score (GS) ≥ 7) in patients with histologically proven prostate cancer (PCa). Methods A total of 92 patients (mean age: 71.5 years, range: 47–89 years) who had been diagnosed as PCa and undergone 3 T-MRI including DWI (b values, 0, 100, 1000, 2000s/mm2) were included in this study. The DKI parameters, namely apparent diffusion for non-Gaussian distribution (Dapp) and apparent kurtosis coefficient (Kapp), were calculated by dedicated software using mono-exponential and diffusion kurtosis models for quantitation. The measurement was performed for a whole tumor after segmentation, and pathologic topographic maps or systemic biopsy results served as the reference standard for segmentation. To compare the diagnostic performance of each parameter for determination of CSC, pair-wise comparison of receiver operating characteristic (ROC) curves was performed. Results The study population consisted of GS 6 (n = 18), GS 7 (n = 31), GS 8 (n = 25), GS 9 (n = 15) and GS 10 (n = 3) patients. The area under the ROC curve of Kapp (0.707, 95% CI 0.603–0.798) for discriminating CSC from non-CSC was not significantly different from those of mono-exponential ADC (0.725, 0.622–0.813, P = 0.2175) or Dapp (0.726, 0.623–0.814, P = 0.9628). Diagnostic predictive values of Kapp were estimated to a maximum accuracy of 78%, a sensitivity of 86%, and a specificity of 47%, while those of mono-exponential ADC were 75, 81, and 53%, respectively. Conclusion The DKI parameters showed a diagnostic performance comparable to mono-exponential ADC for determination of CSC in patients with PCa. Keywords Magnetic resonance imaging (MRI) · Diffusion kurtosis imaging (DKI) · Risk assessment · Prostate cancer · Gleason score
Introduction Prostate cancer (PCa) is the second most common cancer in men and the fifth leading cause of cancer mortality in men [1]. There have been many efforts to derive optimal individualized treatment plans, since there are diverse treatment options according to cancer aggressiveness, staging, and risk * Seung Ho Kim [email protected] 1
Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae‑ro 875, Haeundae‑gu, Busan 48108, Korea
of recurrence. However, due to the sampling error of the transrectal ultrasound guided systemic biopsy (TRUS-Bx) [2] and the possibility of complications from the invasive approach [3], evaluation of tumor aggressiveness with
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