Measured multipoint ultra-high b-value diffusion MRI in the assessment of MRI-detected prostate lesions

• Verfasst von: Tavakoli, Andrej [VerfasserIn]
• Verfasst von: Kuder, Tristan Anselm [VerfasserIn]
• Verfasst von: Tichy, Diana [VerfasserIn]
• Verfasst von: Radtke, Jan Philipp [VerfasserIn]
• Verfasst von: Görtz, Magdalena [VerfasserIn]
• Verfasst von: Schütz, Viktoria [VerfasserIn]
• Verfasst von: Stenzinger, Albrecht [VerfasserIn]
• Verfasst von: Hohenfellner, Markus [VerfasserIn]
• Verfasst von: Schlemmer, Heinz-Peter [VerfasserIn]
• Verfasst von: Bonekamp, David [VerfasserIn]
• Titel: Measured multipoint ultra-high b-value diffusion MRI in the assessment of MRI-detected prostate lesions
• Verf.angabe: Tavakoli, Anoshirwan Andrej MD; Kuder, Tristan Anselm PhD; Tichy, Diana PhD; Radtke, Jan Philipp MD; Görtz, Magdalena MD; Schütz, Viktoria MD; Stenzinger, Albrecht MD; Hohenfellner, Markus MD; Schlemmer, Heinz-Peter MD, PhD; Bonekamp, David MD
• E-Jahr: 2021
• Jahr: February 2021
• Umfang: 9 S.
• Fussnoten: Gesehen am 01.12.2021
• Titel Quelle: Enthalten in: Investigative radiology
• Ort Quelle: Philadelphia, Pa. : Lippincott Williams & Wilkins, 1966
• Jahr Quelle: 2021
• Band/Heft Quelle: 56(2021), 2, Seite 94-102
• ISSN Quelle: 1536-0210
• DOI: doi:10.1097/RLI.0000000000000712
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1751086658

Abstract

Objectives - The aim of this study was to assess quantitative ultra-high b-value (UHB) diffusion magnetic resonance imaging (MRI)-derived parameters in comparison to standard clinical apparent diffusion coefficient (SD-ADC-2b-1000, SD-ADC-2b-1500) for the prediction of clinically significant prostate cancer, defined as Gleason Grade Group greater than or equal to 2. - Materials and Methods - Seventy-three patients who underwent 3-T prostate MRI with diffusion-weighted imaging acquired at b = 50/500/1000/1500s/mm2 and b = 100/500/1000/1500/2250/3000/4000 s/mm2 were included. Magnetic resonance lesions were segmented manually on individual sequences, then matched to targeted transrectal ultrasonography/MRI fusion biopsies. Monoexponential 2-point and multipoint fits of standard diffusion and of UHB diffusion were calculated with incremental b-values. Furthermore, a kurtosis fit with parameters Dapp and Kapp with incremental b-values was obtained. Each parameter was examined for prediction of clinically significant prostate cancer using bootstrapped receiver operating characteristics and decision curve analysis. Parameter models were compared using Vuong test. - Results - Fifty of 73 men (age, 66 years [interquartile range, 61-72]; prostate-specific antigen, 6.6 ng/mL [interquartile range, 5-9.7]) had 64 MRI-detected lesions. The performance of SD-ADC-2b-1000 (area under the curve, 0.82) and SD-ADC-2b-1500 (area under the curve, 0.82) was not statistically different (P = 0.99), with SD-ADC-2b-1500 selected as reference. Compared with the reference model, none of the 19 tested logistic regression parameter models including multipoint and 2-point UHB-ADC, Dapp, and Kapp with incremental b-values of up to 4000 s/mm2 outperformed SD-ADC-2b-1500 (all P's > 0.05). Decision curve analysis confirmed these results indicating no higher net benefit for UHB parameters in comparison to SD-ADC-2b-1500 in the clinically important range from 3% to 20% of cancer threshold probability. Net reduction analysis showed no reduction of MR lesions requiring biopsy. - Conclusions - Despite evaluation of a large b-value range and inclusion of 2-point, multipoint, and kurtosis models, none of the parameters provided better predictive performance than standard 2-point ADC measurements using b-values 50/1000 or 50/1500. Our results suggest that most of the diagnostic benefits available in diffusion MRI are already represented in an ADC composed of one low and one 1000 to 1500 s/mm2 b-value.