Differentiating prostate cancer from benign prostatic hyperplasia using whole-lesion histogram and texture analysis of diffusion- and T2-weighted imaging.

To explore the usefulness of analyzing histograms and textures of apparent diffusion coefficient (ADC) maps and T2-weighted (T2W) images to differentiate prostatic cancer (PCa) from benign prostatic hyperplasia (BPH) using histopathology as the reference.

Ninety patients with PCa and 112 patients with BPH were included in this retrospective study. Differences in whole-lesion histograms and texture parameters of ADC maps and T2W images between PCa and BPH patients were evaluated using the independent samples t-test. The diagnostic performance of ADC maps and T2W images in being able to differentiate PCa from BPH was assessed using receiver operating characteristic (ROC) curves. RESULTS : The mean, median, 5th, and 95th percentiles of ADC values in images from PCa patients were significantly lower than those from BPH patients (p < 0.05). Significant differences were observed in the means, standard deviations, medians, kurtosis, skewness, and 5th percentile values of T2W image between PCa and BPH patients (p < 0.05). The ADC5th showed the largest AUC (0.906) with a sensitivity of 83.3 % and specificity of 89.3 %. The diagnostic performance of the T2W image histogram and texture analysis was moderate and had the largest AUC of 0.634 for T2WKurtosis with a sensitivity and specificity of 48.9% and 79.5 %, respectively. The diagnostic performance of the combined ADC5th & T2WKurtosis parameters was also similar to that of the ADC5th & ADCDiff-Variance.

Histogram and texture parameters derived from the ADC maps and T2W images for entire prostatic lesions could be used as imaging biomarkers to differentiate PCa and BPH biologic characteristics, however, histogram parameters outperformed texture parameters in the diagnostic performance.

Cancer imaging : the official publication of the International Cancer Imaging Society. 2021 Sep 27*** epublish ***

Pengyi Xing, Luguang Chen, Qingsong Yang, Tao Song, Chao Ma, Robert Grimm, Caixia Fu, Tiegong Wang, Wenjia Peng, Jianping Lu

Department of Radiology, Changhai Hospital of Shanghai, The Second Military Medical University, No.168 Changhai Road, 200433, Shanghai, China., Application Predevelopment, Siemens Healthcare, Erlangen, Germany., MR Application Development, Siemens Shenzhen Magnetic Resonance Ltd, Shenzhen, China., Department of Radiology, Changhai Hospital of Shanghai, The Second Military Medical University, No.168 Changhai Road, 200433, Shanghai, China. .

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