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Performance of Diffusion Kurtosis Imaging Versus Diffusion Tensor Imaging in Discriminating Between Benign Tissue, Low and High Gleason Grade Prostate Cancer.

Authors
  • Di Trani, Maria Giovanna1
  • Nezzo, Marco2
  • Caporale, Alessandra S3
  • De Feo, Riccardo4
  • Miano, Roberto5
  • Mauriello, Alessandro6
  • Bove, Pierluigi5
  • Manenti, Guglielmo2
  • Capuani, Silvia7
  • 1 Centro Fermi - Museo Storico della Fisica e Centro Studi e Ricerche Enrico Fermi, Rome, Italy; Department of Anatomical, Histological, Forensic and Locomotor System Science, Sapienza University of Rome, Via A. Scarpa 16, Rome 00161, Italy. Electronic address: [email protected] , (Italy)
  • 2 Department of Diagnostic and Interventional Radiology, Molecular Imaging and Radiotherapy, PTV Foundation, Tor Vergata University of Rome, Rome, Italy. , (Italy)
  • 3 Department of Physics, CNR ISC, UOS Roma Sapienza, Sapienza University of Rome, Rome, Italy; Department of Radiology, University of Pennsylvania Hospital, Founders Pavilion, Philadelphia, Pennsylvania. , (Italy)
  • 4 Centro Fermi - Museo Storico della Fisica e Centro Studi e Ricerche Enrico Fermi, Rome, Italy; Department of Physics, CNR ISC, UOS Roma Sapienza, Sapienza University of Rome, Rome, Italy. , (Italy)
  • 5 Urology Unit, Department of Experimental Medicine and Surgery, PTV Foundation, Tor Vergata University of Rome, Rome, Italy. , (Italy)
  • 6 Anatomic Pathology, Department of Experimental Medicine and Surgery, PTV Foundation, Tor Vergata University of Rome, Rome, Italy. , (Italy)
  • 7 Department of Physics, CNR ISC, UOS Roma Sapienza, Sapienza University of Rome, Rome, Italy. , (Italy)
Type
Published Article
Journal
Academic radiology
Publication Date
Oct 01, 2019
Volume
26
Issue
10
Pages
1328–1337
Identifiers
DOI: 10.1016/j.acra.2018.11.015
PMID: 30545680
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To investigate the performance of diffusion kurtosis imaging (DKI) and diffusion tensor imaging (DTI) in discriminating benign tissue, low- and high-grade prostate adenocarcinoma (PCa). Forty-eight patients with biopsy-proven PCa of different Gleason grade (GG), who provided written informed consent, were enrolled. All subjects underwent 3T DWI examinations by using b values 0, 500, 1000, 1500, 2000, and 2500 s/mm2 and six gradient directions. Mean diffusivity, fractional anisotropy (FA), apparent kurtosis (K), apparent kurtosis-derived diffusivity (D), and proxy fractional kurtosis anisotropy (KFA) maps were obtained. Regions of interest were selected in PCa, in the contralateral benign zone, and in the peritumoral area. Histogram analysis was performed by measuring mean, 10th, 25th, and 90th (p90) percentile of the whole-lesion volume. Kruskal-Wallis test with Bonferroni correction was used to assess significant differences between different regions of interest. The correlation between diffusion metrics and GG and between DKI and DTI parameters was evaluated with Pearson's test. ROC curve analysis was carried out to analyze the ability of histogram variables to differentiate low- and high-GG PCa. All metrics significantly discriminated PCa from benign and from peritumoral tissue (except for K, KFAp90, and FA). Kp90 showed the highest correlation with GG and the best diagnostic ability (area under the curve = 0.84) in discriminating low- from high-risk PCa. Compared to DTI, DKI provides complementary and additional information about prostate cancer tissue, resulting more sensitive to PCa-derived modifications and more accurate in discriminating low- and high-risk PCa. Copyright © 2018 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.

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