Evaluation of the value of DWI combined with T2 mapping sequences to identify prostate cancer and benign prostatic hyperplasia
Objective:The efficacy of combining diffusion weighted imaging(DWI)with T2 mapping sequences in differentiating prostate cancer(PCa)and benign prostatic hyperplasia(BPH).Materials and Methods:We conducted a retrospective analysis of data from 56 patients diagnosed with PCa and 40 patients with BPH,who underwent 3.0 T MRI examinations at our hospital and received pathological confirmation.The scanning sequences included T1WI,T2WI,DWI and T2 mapping sequences.Two observers independently measured the apparent diffusion coefficient(ADC)values and T2 values of the lesions in both groups.The intra-class correlation coefficient(ICC)was used to assess inter-observer agreement.Differences in ADC values and T2 values between the two groups were analyzed using independent samples t-test or Mann-Whitney U test.Logistic regression was employed to create diagnostic models using discrepant parameters and baseline information.ROC curves were constructed to evaluate the diagnostic efficacy of the differentiated parameters and the joint model.The DeLong test was used to compare differences in the area under the ROC curve(AUC).Spearman's correlation coefficient was calculated to assess the correlation between ADC values and T2 values.Results:Excellent agreement was observed between the measurements of the two observers(ICC>0.75).The PCa group exhibited significantly lower ADC and T2 values compared to the BPH group(P<0.01).The AUC values for ADC,T2,ADC-T2 joint model,and ADC-T2-age-total prostate specific antigen(TPSA)joint model in distinguishing PCa from BPH were 0.843,0.830,0.896 and 0.927.DeLong's test showed statistically significant differences in the ROC curves for ADC and ADC-T2 jointly and for ADC,T2,ADC-T2 model and ADC-T2-age-TPSA joint model(P<0.05).ADC values were positively correlated with T2 values(r=0.331,P<0.01).Conclusions:DWI and T2 mapping hold substantial value in differentiating between PCa and BPH.The diagnostic efficacy improves when combining these sequences with clinical indicators such as age and TPSA.This combined imaging approach offers promising non-invasive diagnostic guidance for PCa and BPH in clinical settings.