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Usefulness of Bi-Parametric Magnetic Resonance Imaging with b=1,800 s/mm2 Diffusion-Weighted Imaging for Diagnosing Clinically Significant Prostate Cancer

The World Journal of Men′s Health 2020년 38권 3호 p.370 ~ 376
이승수, 이동훈, Song Won-Hoon, 남종길, 한지연, 이현정, 김태언, 박성우,
소속 상세정보
이승수 ( Lee Seung-Soo ) - Pusan National University Yangsan Hospital Department of Urology
이동훈 ( Lee Dong-Hoon ) - Pusan National University Yangsan Hospital Department of Urology
 ( Song Won-Hoon ) - Pusan National University Yangsan Hospital Department of Urology
남종길 ( Nam Jong-Kil ) - Pusan National University Yangsan Hospital Department of Urology
한지연 ( Han Ji-Yeon ) - Pusan National University Yangsan Hospital Department of Urology
이현정 ( Lee Hyun-Jung ) - Pusan National University Yangsan Hospital Department of Pathology
김태언 ( Kim Tae-Un ) - Pusan National University Yangsan Hospital Department of Radiology
박성우 ( Park Sung-Woo ) - Pusan National University Yangsan Hospital Department of Urology

Abstract


Purpose: This study was conducted to compare the accuracy of bi-parametric magnetic resonance imaging (bpMRI) with high b-value (b=1,000 s/mm2, b1000) diffusion-weighted imaging (DWI) to that of bpMRI with ultra-high b-value (b=1,800 s/mm2, b1800) DWI to detect clinically significant prostate cancer (csPCa).

Materials and Methods: A total of 408 patients with suspected PCa were evaluated by bpMRI prior to biopsy. One reader retrospectively reviewed all images for confirmation of Prostate Imaging?Reporting and Data System (PI-RADS) score. Cognitive magnetic resonance/ultrasound fusion target biopsy was done for all visible lesions (PI-RADS 3?5). Systematic biopsy was done for all cases. The csPCa detection rates were compared according to the bpMRI protocol (with/without b1800 DWI) or PI-RADS score. The accuracy of PI-RADS score was estimated using receiver operating characteristics curve. The signal intensity (SI) ratio (visible lesion/surrounding background) was evaluated.

Results: Among 164 men confirmed having PCa, 102 had csPCa (Gleason score≥7). Proportions of PI-RADS score 1?2/3/4/5 without b1800 DWI (n=133) and with b1800 DWI (n=275) were 19.5%/57.9%/15.8%/6.8% and 21.1%/48.7%/22.2%/8.0%, respectively. csPCa detection rates with/without b1800 DWI were 27.6%/19.5% (p=0.048), respectively. Areas under the curve of PI-RADS grading with/without b1800 DWI for csPCa detection were 0.885 and 0.705, respectively. The SI ratio in b1800 DWI was higher than that in b1000 DWI (p<0.001).

Conclusions: Adding b1800 DWI to bpMRI protocol improved the diagnostic accuracy and detection rate of csPCa. The higher SI ratio (lesion/background) in b1800 DWI enabled clearer identification of lesions.

키워드

Diagnostic imaging; Image-guided biopsy; Magnetic resonance imaging; Prostatic neoplasms

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