Skip to main content
Top
Published in: Abdominal Radiology 12/2020

01-12-2020 | Prostate Cancer | Pelvis

Comparison of diagnostic performance between diffusion kurtosis imaging parameters and mono-exponential ADC for determination of clinically significant cancer in patients with prostate cancer

Authors: Hyungin Park, Seung Ho Kim, Yedaun Lee, Jung Hee Son

Published in: Abdominal Radiology | Issue 12/2020

Login to get access

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.
Literature
1.
go back to reference Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018-2020) Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 68:394-424. https://doi.org/10.3322/caac.21492 Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A (2018-2020) Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin 68:394-424. https://​doi.​org/​10.​3322/​caac.​21492
2.
go back to reference Corcoran NM, Hong MK, Casey RG, Hurtado-Coll A, Peters J, Harewood L, Goldenberg SL, Hovens CM, Costello AJ, Gleave ME (2011) Upgrade in Gleason score between prostate biopsies and pathology following radical prostatectomy significantly impacts upon the risk of biochemical recurrence. BJU international 108 (8b):E202-E210. https://doi.org/https://doi.org/10.1111/j.1464-410X.2011.10119.x Corcoran NM, Hong MK, Casey RG, Hurtado-Coll A, Peters J, Harewood L, Goldenberg SL, Hovens CM, Costello AJ, Gleave ME (2011) Upgrade in Gleason score between prostate biopsies and pathology following radical prostatectomy significantly impacts upon the risk of biochemical recurrence. BJU international 108 (8b):E202-E210. https://​doi.​org/​https://​doi.​org/​10.​1111/​j.​1464-410X.​2011.​10119.​x
4.
go back to reference Vargas HA, Akin O, Franiel T, Mazaheri Y, Zheng J, Moskowitz C, Udo K, Eastham J, Hricak H (2011) Diffusion-weighted endorectal MR imaging at 3 T for prostate cancer: tumor detection and assessment of aggressiveness. Radiology 259 (3):775-784. https://doi.org/https://doi.org/10.1148/radiol.11102066 Vargas HA, Akin O, Franiel T, Mazaheri Y, Zheng J, Moskowitz C, Udo K, Eastham J, Hricak H (2011) Diffusion-weighted endorectal MR imaging at 3 T for prostate cancer: tumor detection and assessment of aggressiveness. Radiology 259 (3):775-784. https://​doi.​org/​https://​doi.​org/​10.​1148/​radiol.​11102066
5.
go back to reference Jung SI, Donati OF, Vargas HA, Goldman D, Hricak H, Akin O (2013) Transition zone prostate cancer: incremental value of diffusion-weighted endorectal MR imaging in tumor detection and assessment of aggressiveness. Radiology 269 (2):493-503. https://doi.org/https://doi.org/10.1148/radiol.13130029 Jung SI, Donati OF, Vargas HA, Goldman D, Hricak H, Akin O (2013) Transition zone prostate cancer: incremental value of diffusion-weighted endorectal MR imaging in tumor detection and assessment of aggressiveness. Radiology 269 (2):493-503. https://​doi.​org/​https://​doi.​org/​10.​1148/​radiol.​13130029
6.
go back to reference Si Y, Liu R-b (2018) Diagnostic performance of Monoexponential DWI versus diffusion kurtosis imaging in prostate Cancer: a systematic review and meta-analysis. American Journal of Roentgenology 211 (2):358-368. https://doi.org/https://doi.org/10.2214/AJR.17.18934 Si Y, Liu R-b (2018) Diagnostic performance of Monoexponential DWI versus diffusion kurtosis imaging in prostate Cancer: a systematic review and meta-analysis. American Journal of Roentgenology 211 (2):358-368. https://​doi.​org/​https://​doi.​org/​10.​2214/​AJR.​17.​18934
7.
go back to reference Rosenkrantz AB, Padhani AR, Chenevert TL, Koh DM, De Keyzer F, Taouli B, Le Bihan D (2015) Body diffusion kurtosis imaging: basic principles, applications, and considerations for clinical practice. Journal of Magnetic Resonance Imaging 42 (5):1190-1202. https://doi.org/https://doi.org/10.1002/jmri.24985 Rosenkrantz AB, Padhani AR, Chenevert TL, Koh DM, De Keyzer F, Taouli B, Le Bihan D (2015) Body diffusion kurtosis imaging: basic principles, applications, and considerations for clinical practice. Journal of Magnetic Resonance Imaging 42 (5):1190-1202. https://​doi.​org/​https://​doi.​org/​10.​1002/​jmri.​24985
8.
go back to reference Jensen JH, Helpern JA, Ramani A, Lu H, Kaczynski K (2005) Diffusional kurtosis imaging: the quantification of non-gaussian water diffusion by means of magnetic resonance imaging. Magnetic Resonance in Medicine: An Official Journal of the International Society for Magnetic Resonance in Medicine 53 (6):1432-1440. https://doi.org/https://doi.org/10.1002/mrm.20508 Jensen JH, Helpern JA, Ramani A, Lu H, Kaczynski K (2005) Diffusional kurtosis imaging: the quantification of non-gaussian water diffusion by means of magnetic resonance imaging. Magnetic Resonance in Medicine: An Official Journal of the International Society for Magnetic Resonance in Medicine 53 (6):1432-1440. https://​doi.​org/​https://​doi.​org/​10.​1002/​mrm.​20508
9.
go back to reference Van Cauter S, Veraart J, Sijbers J, Peeters RR, Himmelreich U, De Keyzer F, Van Gool SW, Van Calenbergh F, De Vleeschouwer S, Van Hecke W (2012) Gliomas: diffusion kurtosis MR imaging in grading. Radiology 263 (2):492-501. https://doi.org/https://doi.org/10.1148/radiol.12110927 Van Cauter S, Veraart J, Sijbers J, Peeters RR, Himmelreich U, De Keyzer F, Van Gool SW, Van Calenbergh F, De Vleeschouwer S, Van Hecke W (2012) Gliomas: diffusion kurtosis MR imaging in grading. Radiology 263 (2):492-501. https://​doi.​org/​https://​doi.​org/​10.​1148/​radiol.​12110927
10.
go back to reference Barrett T, McLean M, Priest AN, Lawrence EM, Patterson AJ, Koo BC, Patterson I, Warren AY, Doble A, Gnanapragasam VJ (2018) Diagnostic evaluation of magnetization transfer and diffusion kurtosis imaging for prostate cancer detection in a re-biopsy population. European radiology 28 (8):3141-3150. https://doi.org/https://doi.org/10.1007/s00330-017-5169-1 Barrett T, McLean M, Priest AN, Lawrence EM, Patterson AJ, Koo BC, Patterson I, Warren AY, Doble A, Gnanapragasam VJ (2018) Diagnostic evaluation of magnetization transfer and diffusion kurtosis imaging for prostate cancer detection in a re-biopsy population. European radiology 28 (8):3141-3150. https://​doi.​org/​https://​doi.​org/​10.​1007/​s00330-017-5169-1
11.
go back to reference Roethke MC, Kuder TA, Kuru TH, Fenchel M, Hadaschik BA, Laun FB, Schlemmer H-P, Stieltjes B (2015) Evaluation of diffusion kurtosis imaging versus standard diffusion imaging for detection and grading of peripheral zone prostate cancer. Investigative radiology 50 (8):483-489. https://doi.org/https://doi.org/10.1097/RLI.0000000000000155 Roethke MC, Kuder TA, Kuru TH, Fenchel M, Hadaschik BA, Laun FB, Schlemmer H-P, Stieltjes B (2015) Evaluation of diffusion kurtosis imaging versus standard diffusion imaging for detection and grading of peripheral zone prostate cancer. Investigative radiology 50 (8):483-489. https://​doi.​org/​https://​doi.​org/​10.​1097/​RLI.​0000000000000155​
12.
go back to reference Toivonen J, Merisaari H, Pesola M, Taimen P, Bostrom PJ, Pahikkala T, Aronen HJ, Jambor I (2015) Mathematical models for diffusion-weighted imaging of prostate cancer using b values up to 2000s/mm2: Correlation with Gleason score and repeatability of region of interest analysis. Magnetic resonance in medicine 74 (4):1116-1124. https://doi.org/https://doi.org/10.1002/mrm.25482 Toivonen J, Merisaari H, Pesola M, Taimen P, Bostrom PJ, Pahikkala T, Aronen HJ, Jambor I (2015) Mathematical models for diffusion-weighted imaging of prostate cancer using b values up to 2000s/mm2: Correlation with Gleason score and repeatability of region of interest analysis. Magnetic resonance in medicine 74 (4):1116-1124. https://​doi.​org/​https://​doi.​org/​10.​1002/​mrm.​25482
13.
go back to reference Wang Q, Li H, Yan X, Wu C-J, Liu X-S, Shi H-B, Zhang Y-D (2015) Histogram analysis of diffusion kurtosis magnetic resonance imaging in differentiation of pathologic Gleason grade of prostate cancer. In: Urologic oncology: seminars and original investigations. vol 8. Elsevier, pp 337. e315-337. e324. https://doi.org/https://doi.org/10.1016/j.urolonc.2015.05.005 Wang Q, Li H, Yan X, Wu C-J, Liu X-S, Shi H-B, Zhang Y-D (2015) Histogram analysis of diffusion kurtosis magnetic resonance imaging in differentiation of pathologic Gleason grade of prostate cancer. In: Urologic oncology: seminars and original investigations. vol 8. Elsevier, pp 337. e315-337. e324. https://​doi.​org/​https://​doi.​org/​10.​1016/​j.​urolonc.​2015.​05.​005
14.
go back to reference Rosenkrantz AB, Sigmund EE, Johnson G, Babb JS, Mussi TC, Melamed J, Taneja SS, Lee VS, Jensen JH (2012) Prostate cancer: feasibility and preliminary experience of a diffusional kurtosis model for detection and assessment of aggressiveness of peripheral zone cancer. Radiology 264 (1):126-135. https://doi.org/https://doi.org/10.1148/radiol.12112290 Rosenkrantz AB, Sigmund EE, Johnson G, Babb JS, Mussi TC, Melamed J, Taneja SS, Lee VS, Jensen JH (2012) Prostate cancer: feasibility and preliminary experience of a diffusional kurtosis model for detection and assessment of aggressiveness of peripheral zone cancer. Radiology 264 (1):126-135. https://​doi.​org/​https://​doi.​org/​10.​1148/​radiol.​12112290
16.
go back to reference Wu C-J, Zhang Y-D, Bao M-L, Li H, Wang X-N, Liu X-S, Shi H-B (2017) Diffusion kurtosis imaging helps to predict upgrading in biopsy-proven prostate Cancer with a Gleason score of 6. American Journal of Roentgenology 209 (5):1081-1087. https://doi.org/https://doi.org/10.2214/AJR.16.17781 Wu C-J, Zhang Y-D, Bao M-L, Li H, Wang X-N, Liu X-S, Shi H-B (2017) Diffusion kurtosis imaging helps to predict upgrading in biopsy-proven prostate Cancer with a Gleason score of 6. American Journal of Roentgenology 209 (5):1081-1087. https://​doi.​org/​https://​doi.​org/​10.​2214/​AJR.​16.​17781
17.
go back to reference Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA (2016-2020) The 2014 International Society of Urological Pathology (ISUP) consensus conference on Gleason grading of prostatic carcinoma. The American journal of surgical pathology 40 (2):244-252. https://doi.org/10.1097/PAS.0000000000000530 Epstein JI, Egevad L, Amin MB, Delahunt B, Srigley JR, Humphrey PA (2016-2020) The 2014 International Society of Urological Pathology (ISUP) consensus conference on Gleason grading of prostatic carcinoma. The American journal of surgical pathology 40 (2):244-252. https://​doi.​org/​10.​1097/​PAS.​0000000000000530​
18.
go back to reference Tamada T, Prabhu V, Li J, Babb JS, Taneja SS, Rosenkrantz AB (2017) Prostate cancer: diffusion-weighted MR imaging for detection and assessment of aggressiveness - comparison between conventional and kurtosis models. Radiology 284 (1):100-108. https://doi.org/https://doi.org/10.1148/radiol.2017162321 Tamada T, Prabhu V, Li J, Babb JS, Taneja SS, Rosenkrantz AB (2017) Prostate cancer: diffusion-weighted MR imaging for detection and assessment of aggressiveness - comparison between conventional and kurtosis models. Radiology 284 (1):100-108. https://​doi.​org/​https://​doi.​org/​10.​1148/​radiol.​2017162321
19.
go back to reference Shan Y, Chen X, Liu K, Zeng M, Zhou J (2019) Prostate cancer aggressive prediction: preponderant diagnostic performances of intravoxel incoherent motion (IVIM) imaging and diffusion kurtosis imaging (DKI) beyond ADC at 3.0 T scanner with gleason score at final pathology. Abdominal Radiology 44 (10):3441-3452. https://doi.org/https://doi.org/10.1007/s00261-019-02075-3 Shan Y, Chen X, Liu K, Zeng M, Zhou J (2019) Prostate cancer aggressive prediction: preponderant diagnostic performances of intravoxel incoherent motion (IVIM) imaging and diffusion kurtosis imaging (DKI) beyond ADC at 3.0 T scanner with gleason score at final pathology. Abdominal Radiology 44 (10):3441-3452. https://​doi.​org/​https://​doi.​org/​10.​1007/​s00261-019-02075-3
20.
go back to reference Ding K, Yao Y, Gao Y, Lu X, Chen H, Tang Q, Hua C, Zhou M, Zou X, Yin Q (2019) Diagnostic evaluation of diffusion kurtosis imaging for prostate cancer: Detection in a biopsy population. European journal of radiology 118:138-146. https://doi.org/https://doi.org/10.1016/j.ejrad.2019.07.009 Ding K, Yao Y, Gao Y, Lu X, Chen H, Tang Q, Hua C, Zhou M, Zou X, Yin Q (2019) Diagnostic evaluation of diffusion kurtosis imaging for prostate cancer: Detection in a biopsy population. European journal of radiology 118:138-146. https://​doi.​org/​https://​doi.​org/​10.​1016/​j.​ejrad.​2019.​07.​009
21.
go back to reference Park SY, Jung DC, Oh YT, Cho NH, Choi YD, Rha KH, Hong SJ, Han K (2016) Prostate cancer: PI-RADS version 2 helps preoperatively predict clinically significant cancers. Radiology 280 (1):108-116. https://doi.org/https://doi.org/10.1148/radiol.16151133 Park SY, Jung DC, Oh YT, Cho NH, Choi YD, Rha KH, Hong SJ, Han K (2016) Prostate cancer: PI-RADS version 2 helps preoperatively predict clinically significant cancers. Radiology 280 (1):108-116. https://​doi.​org/​https://​doi.​org/​10.​1148/​radiol.​16151133
22.
go back to reference Chen S, Yang Y, Peng T, Yu X, Deng H, Guo Z (2020) The prediction value of PI-RADS v2 score in high-grade Prostate Cancer: a multicenter retrospective study. International journal of medical sciences 17 (10):1366-1374. https://doi.org/https://doi.org/10.7150/ijms.45730 Chen S, Yang Y, Peng T, Yu X, Deng H, Guo Z (2020) The prediction value of PI-RADS v2 score in high-grade Prostate Cancer: a multicenter retrospective study. International journal of medical sciences 17 (10):1366-1374. https://​doi.​org/​https://​doi.​org/​10.​7150/​ijms.​45730
24.
go back to reference Bourne R, Kurniawan N, Cowin G, Sved P, Watson G (2011) 16 T diffusion microimaging of fixed prostate tissue: preliminary findings. Magnetic resonance in medicine 66 (1):244-247. https://doi.org/https://doi.org/10.1002/mrm.22778 Bourne R, Kurniawan N, Cowin G, Sved P, Watson G (2011) 16 T diffusion microimaging of fixed prostate tissue: preliminary findings. Magnetic resonance in medicine 66 (1):244-247. https://​doi.​org/​https://​doi.​org/​10.​1002/​mrm.​22778
25.
go back to reference Jia G, Abaza R, Williams JD, Zynger DL, Zhou J, Shah ZK, Patel M, Sammet S, Wei L, Bahnson RR (2011) Amide proton transfer MR imaging of prostate cancer: a preliminary study. Journal of Magnetic Resonance Imaging 33 (3):647-654. https://doi.org/https://doi.org/10.1002/jmri.22480 Jia G, Abaza R, Williams JD, Zynger DL, Zhou J, Shah ZK, Patel M, Sammet S, Wei L, Bahnson RR (2011) Amide proton transfer MR imaging of prostate cancer: a preliminary study. Journal of Magnetic Resonance Imaging 33 (3):647-654. https://​doi.​org/​https://​doi.​org/​10.​1002/​jmri.​22480
26.
go back to reference Takayama Y, Nishie A, Sugimoto M, Togao O, Asayama Y, Ishigami K, Ushijima Y, Okamoto D, Fujita N, Yokomizo A, Keupp J, Honda H (2016) Amide proton transfer (APT) magnetic resonance imaging of prostate cancer: comparison with Gleason scores. Magnetic Resonance Materials in Physics 29 (4):671-679. https://doi.org/https://doi.org/10.1007/s10334-016-0537-4 Takayama Y, Nishie A, Sugimoto M, Togao O, Asayama Y, Ishigami K, Ushijima Y, Okamoto D, Fujita N, Yokomizo A, Keupp J, Honda H (2016) Amide proton transfer (APT) magnetic resonance imaging of prostate cancer: comparison with Gleason scores. Magnetic Resonance Materials in Physics 29 (4):671-679. https://​doi.​org/​https://​doi.​org/​10.​1007/​s10334-016-0537-4
28.
go back to reference Sun K, Chen X, Chai W, Fei X, Fu C, Yan X, Zhan Y, Chen K, Shen K, Yan F (2015) Breast cancer: diffusion kurtosis MR imaging - diagnostic accuracy and correlation with clinical-pathologic factors. Radiology 277 (1):46-55. https://doi.org/https://doi.org/10.1148/radiol.15141625 Sun K, Chen X, Chai W, Fei X, Fu C, Yan X, Zhan Y, Chen K, Shen K, Yan F (2015) Breast cancer: diffusion kurtosis MR imaging - diagnostic accuracy and correlation with clinical-pathologic factors. Radiology 277 (1):46-55. https://​doi.​org/​https://​doi.​org/​10.​1148/​radiol.​15141625
Metadata
Title
Comparison of diagnostic performance between diffusion kurtosis imaging parameters and mono-exponential ADC for determination of clinically significant cancer in patients with prostate cancer
Authors
Hyungin Park
Seung Ho Kim
Yedaun Lee
Jung Hee Son
Publication date
01-12-2020
Publisher
Springer US
Published in
Abdominal Radiology / Issue 12/2020
Print ISSN: 2366-004X
Electronic ISSN: 2366-0058
DOI
https://doi.org/10.1007/s00261-020-02776-0

Other articles of this Issue 12/2020

Abdominal Radiology 12/2020 Go to the issue

Special Section: Prostate cancer

PI-RADS: what is new and how to use it