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IVIM Parameters on MRI Could Predict ISUP Risk Groups of Prostate Cancers on Radical Prostatectomy

Authors
  • Chang, Chun-Bi1, 2
  • Lin, Yu-Chun2, 3
  • Wong, Yon-Cheong1, 2
  • Lin, Shin-Nan1, 2
  • Lin, Chien-Yuan4
  • Lin, Yu-Han3
  • Sheng, Ting-Wen2, 5
  • Huang, Chen-Chih2, 5
  • Yang, Lan-Yan6
  • Wang, Li-Jen2, 5
  • 1 Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Taoyuan
  • 2 Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan
  • 3 Department of Medical Imaging and Intervention, Chang Gung Memorial Hospital, Taoyuan
  • 4 Department of Clinical Science, General Electric (GE) Healthcare, Taipei
  • 5 Department of Medical Imaging and Intervention, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan
  • 6 Biostatistics Unit of Clinical Trial Center, Chang Gung Memorial Hospital, Taoyuan
Type
Published Article
Journal
Frontiers in Oncology
Publisher
Frontiers Media SA
Publication Date
Jul 01, 2021
Volume
11
Identifiers
DOI: 10.3389/fonc.2021.659014
Source
Frontiers
Keywords
Disciplines
  • Oncology
  • Original Research
License
Green

Abstract

Purpose To elucidate the usefulness of intravoxel incoherent motion (IVIM)/apparent diffusion coefficient (ADC) parameters in preoperative risk stratification using International Society of Urological Pathology (ISUP) grades. Materials and Methods Forty-five prostate cancer (PCa) patients undergoing radical prostatectomy (RP) after prostate multiparametric magnetic resonance imaging (mpMRI) were included. The ISUP grades were categorized into low-risk (I-II) and high-risk (III-V) groups, and the concordance between the preoperative and postoperative grades was analyzed. The largest region of interest (ROI) of the dominant tumor on each IVIM/ADC image was delineated to obtain its histogram values (i.e., minimum, mean, and kurtosis) of diffusivity (D), pseudodiffusivity (D*), perfusion fraction (PF), and ADC. Multivariable logistic regression analysis of the IVIM/ADC parameters without and with preoperative ISUP grades were performed to identify predictors for the postoperative high-risk group. Results Thirty-two (71.1%) of 45 patients had concordant preoperative and postoperative ISUP grades. Dmean, D*kurtosis, PFkurtosis, ADCmin, and ADCmean were significantly associated with the postoperative ISUP risk group (all p < 0.05). Dmean and D*kurtosis (model I, both p < 0.05) could predict the postoperative ISUP high-risk group with an area under the curve (AUC) of 0.842 and a 95% confidence interval (CI) of 0.726–0.958. The addition of D*kurtosis to the preoperative ISUP grade (model II) may enhance prediction performance, with an AUC of 0.907 (95% CI 0.822–0.992). Conclusions The postoperative ISUP risk group could be predicted by Dmean and D*kurtosis from mpMRI, especially D*kurtosis. Obtaining the biexponential IVIM parameters is important for better risk stratification for PCa.

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