Introduction
Materials and methods
Participants
Item | Value |
---|---|
Number of patients | 25 |
Clinically significant prostate cancer lesions | 25 |
Peripheral zone (PZ) lesions | 15 |
Transition zone (TZ) lesions | 10 |
Age (years) | |
Mean ± SD | 70.6 ± 7.34 |
Range | 54–86 |
Initial PSA level (ng/mL) | |
Mean ± SD | 37.0 ± 105 |
Range | 1.78–533 |
Interval between MRI examination and MRGB (days) | |
Mean ± SD | 38.3 ± 33.0 |
Range | 2–122 |
Gleason score | |
3 + 3 | 5 |
3 + 4 | 7 |
4 + 3 | 7 |
4 + 4 | 2 |
4 + 5 | 4 |
MRI
Parameters | Short TR DWI | Long TR DWI |
---|---|---|
Field of view (FOV) (mm) | 300 × 300 | 300 × 300 |
Number of slices | 30 | 30 |
TR (ms) | 1850 | 6000 |
TE (ms) | 70 | 70 |
Acquired voxel size (mm3) | 3.13 × 3.13 × 3.00 | 3.13 × 3.13 × 3.00 |
SENSE reduction factor | 2 | 2 |
Number of packages | 3 | 1 |
b-value (s/mm2) | 0, 1000, 2000 | 0, 1000, 2000 |
Number of signals averaged (NSA) | 2 (b0), 4 (b1000), 8 (b2000) | 2 (b0), 4 (b1000), 8 (b2000) |
Scan time | 3 min 50 s | 3 min 50 s |
MRGB
Histopathologic examination
Clinically significant prostate cancer
Data evaluation
Quantitative and qualitative analysis
Diagnostic performance
Statistical analysis
Results
Quantitative and qualitative analysis
With short TR | With long TR | P value | |
---|---|---|---|
DWI1000 | 2 [2, 3] | 2 [2, 3] | .002 |
DWI2000 | 3 [2, 3] | 3 [2, 3] | .07 |
Diagnostic performance
Region | Parameter | Reader | DWI1000 with short TR | DWI1000 with long TR | P value | DWI2000 with short TR | DWI2000 with long TR | P value |
---|---|---|---|---|---|---|---|---|
PZ + TZ | Sensitivity, % | 1 | 88.5 (23/26) | 88.5 (23/26) | n.s | 88.5 (23/26) | 88.5 (23/26) | n.s |
2 | 88.5 (23/26) | 88.5 (23/26) | n.s | 88.5 (23/26) | 88.5 (23/26) | n.s | ||
3 | 80.8 (21/26) | 80.8 (21/26) | n.s | 80.8 (21/26) | 84.6 (22/26) | n.s | ||
4 | 84.6 (22/26) | 80.8 (21/26) | n.s | 84.6 (22/26) | 88.5 (23/26) | n.s | ||
5 | 84.6 (22/26) | 53.8 (14/26) | 0.01 | 92.3 (24/26) | 69.2 (18/26) | 0.04 | ||
Specificity, % | 1 | 91.3 (42/46) | 89.1 (41/46) | n.s | 89.1 (41/46) | 91.3 (42/46) | n.s | |
2 | 93.5 (43/46) | 91.3 (42/46) | n.s | 91.3 (42/46) | 91.3 (42/46) | n.s | ||
3 | 93.5 (43/46) | 93.5 (43/46) | n.s | 93.5 (43/46) | 93.5 (43/46) | n.s | ||
4 | 91.3 (42/46) | 95.7 (44/46) | n.s | 93.5 (43/46) | 93.5 (43/46) | n.s | ||
5 | 89.1 (41/46) | 80.4 (37/46) | n.s | 84.8 (39/46) | 71.7 (33/46) | n.s | ||
PPV, % | 1 | 85.2 (23/27) | 82.4 (23/28) | NA | 82.4 (23/28) | 85.2 (23/27) | NA | |
2 | 88.5 (23/26) | 85.2 (23/27) | NA | 85.2 (23/27) | 85.2 (23/27) | NA | ||
3 | 87.5 (21/24) | 87.5 (21/24) | NA | 87.5 (21/24) | 88.0 (22/25) | NA | ||
4 | 84.6 (22/26) | 91.3 (42/46) | NA | 88.0 (22/25) | 88.5 (23/26) | NA | ||
5 | 81.5 (22/27) | 60.9 (14/23) | NA | 77.4 (24/31) | 58.1 (18/31) | NA | ||
NPV, % | 1 | 93.3 (42/45) | 93.2 (41/44) | NA | 93.2 (41/44) | 93.3 (42/45) | NA | |
2 | 93.5 (44/46) | 93.3 (42/45) | NA | 93.3 (42/45) | 93.3 (42/45) | NA | ||
3 | 89.6 (43/48) | 89.6 (43/48) | NA | 89.6 (43/48) | 91.5 (43/47) | NA | ||
4 | 91.3 (42/46) | 89.8 (44/49) | NA | 91.5 (43/47) | 93.5 (44/46) | NA | ||
5 | 91.1 (41/45) | 75.5 (37/49) | NA | 95.1 (39/41) | 80.5 (33/41) | NA | ||
Accuracy, % | 1 | 90.3 (65/72) | 88.9 (64/72) | n.s | 88.9 (64/72) | 90.3 (65/72) | n.s | |
2 | 91.7 (67/72) | 90.3 (65/72) | n.s | 90.3 (65/72) | 90.3 (65/72) | n.s | ||
3 | 88.9 (64/72) | 88.9 (64/72) | n.s | 88.9 (64/72) | 90.3 (65/72) | n.s | ||
4 | 88.9 (64/72) | 90.3 (65/72) | n.s | 90.3 (65/72) | 91.7 (67/72) | n.s | ||
5 | 87.5 (63/72) | 70.8 (51/72) | 0.01 | 87.5 (63/72) | 70.8 (51/72) | 0.01 | ||
AUC | 1 | 0.90 | 0.89 | n.s | 0.89 | 0.89 | n.s | |
2 | 0.92 | 0.91 | n.s | 0.91 | 0.91 | n.s | ||
3 | 0.88 | 0.87 | n.s | 0.86 | 0.88 | n.s | ||
4 | 0.88 | 0.89 | n.s | 0.89 | 0.91 | n.s | ||
5 | 0.89 | 0.68 | < 0.001 | 0.93 | 0.74 | 0.001 |
Region | Parameter | Reader | DWI1000 with short TR | DWI1000 with long TR | P value | DWI2000 with short TR | DWI2000 with long TR | P value |
---|---|---|---|---|---|---|---|---|
PZ | Sensitivity, % | 1 | 84.2 (16/19) | 84.2 (16/19) | n.s | 84.2 (16/19) | 84.2 (16/19) | n.s |
2 | 84.2 (16/19) | 84.2 (16/19) | n.s | 84.2 (16/19) | 84.2 (16/19) | n.s | ||
3 | 78.9 (15/19) | 78.9 (15/19) | n.s | 78.9 (15/19) | 84.2 (16/19) | n.s | ||
4 | 78.9 (15/19) | 78.9 (15/19) | n.s | 78.9 (15/19) | 84.2 (16/19) | n.s | ||
5 | 78.9 (15/19) | 47.4 (9/19) | 0.04 | 89.5 (17/19) | 63.2 (12/19) | n.s | ||
Specificity, % | 1 | 91.4 (32/35) | 88.6 (31/35) | n.s | 88.6 (31/35) | 88.6 (31/35) | n.s | |
2 | 91.4 (32/35) | 88.6 (31/35) | n.s | 88.6 (31/35) | 88.6 (31/35) | n.s | ||
3 | 94.3 (33/35) | 94.3 (33/35) | n.s | 94.3 (33/35) | 94.3 (33/35) | n.s | ||
4 | 88.6 (31/35) | 94.3 (33/35) | n.s | 91.4 (32/35) | 91.4 (32/35) | n.s | ||
5 | 88.6 (31/35) | 80.0 (28/35) | n.s | 88.6 (31/35) | 74.3 (26/35) | n.s | ||
PPV, % | 1 | 84.2 (16/19) | 80.0 (16/20) | NA | 80.0 (16/20) | 80.0 (16/20) | NA | |
2 | 84.2 (16/19) | 80.0 (16/20) | NA | 80.0 (16/20) | 80.0 (16/20) | NA | ||
3 | 88.2 (15/17) | 88.2 (15/17) | NA | 88.2 (15/17) | 88.9 (16/18) | NA | ||
4 | 78.9 (15/19) | 88.2 (15/17) | NA | 83.3 (15/18) | 84.2 (16/19) | NA | ||
5 | 78.9 (15/19) | 56.3 (9/16) | NA | 81.0 (17/21) | 57.1 (12/21) | NA | ||
NPV, % | 1 | 91.4 (32/35) | 91.2 (31/34) | NA | 91.2 (31/34) | 91.2 (31/34) | NA | |
2 | 91.4 (32/35) | 91.2 (31/34) | NA | 91.2 (31/34) | 91.2 (31/34) | NA | ||
3 | 89.2 (33/37) | 89.2 (33/37) | NA | 89.2 (33/37) | 91.7 (33/36) | NA | ||
4 | 88.6 (31/35) | 89.2 (33/37) | NA | 88.9 (32/36) | 91.4 (32/35) | NA | ||
5 | 88.6 (31/35) | 73.7 (28/38) | NA | 93.9 (31/33) | 78.8 (26/33) | NA | ||
Accuracy, % | 1 | 88.9 (48/54) | 87.0 (47/54) | n.s | 87.0 (47/54) | 87.0 (47/54) | n.s | |
2 | 88.9 (48/54) | 87.0 (47/54) | n.s | 87.0 (47/54) | 87.0 (47/54) | n.s | ||
3 | 88.9 (48/54) | 88.9 (48/54) | n.s | 88.9 (48/54) | 90.7 (49/54) | n.s | ||
4 | 85.2 (46/54) | 88.9 (48/54) | n.s | 87.0 (47/54) | 88.9 (48/54) | n.s | ||
5 | 85.2 (46/54) | 68.5 (37/54) | n.s | 88.9 (48/54) | 70.4 (38/54) | n.s | ||
AUC, % | 1 | 0.89 | 0.87 | n.s | 0.87 | 0.87 | n.s | |
2 | 0.89 | 0.88 | n.s | 0.87 | 0.88 | n.s | ||
3 | 0.88 | 0.86 | n.s | 0.85 | 0.88 | n.s | ||
4 | 0.84 | 0.85 | n.s | 0.85 | 0.88 | n.s | ||
5 | 0.86 | 0.64 | 0.002 | 0.93 | 0.70 | 0.001 |
Region | Parameter | Reader | DWI1000 with short TR | DWI1000 with long TR | P value | DWI2000 with short TR | DWI2000 with long TR | P value |
---|---|---|---|---|---|---|---|---|
TZ | Sensitivity, % | 1 | 100 (7/7) | 100 (7/7) | n.s | 100 (7/7) | 100 (7/7) | n.s |
2 | 100 (7/7) | 100 (7/7) | n.s | 100 (7/7) | 100 (7/7) | n.s | ||
3 | 85.7 (6/7) | 85.7 (6/7) | n.s | 85.7 (6/7) | 85.7 (6/7) | n.s | ||
4 | 100 (7/7) | 85.7 (6/7) | n.s | 100 (7/7) | 100 (7/7) | n.s | ||
5 | 100 (7/7) | 71.4 (5/7) | n.s | 100 (7/7) | 85.7 (6/7) | n.s | ||
Specificity, % | 1 | 90.9 (10/11) | 90.9 (10/11) | n.s | 90.9 (10/11) | 90.9 (10/11) | n.s | |
2 | 100 (11/11) | 100 (11/11) | n.s | 100 (11/11) | 100 (11/11) | n.s | ||
3 | 90.9 (10/11) | 90.9 (10/11) | n.s | 90.9 (10/11) | 90.9 (10/11) | n.s | ||
4 | 100 (11/11) | 100 (11/11) | n.s | 100 (11/11) | 100 (11/11) | n.s | ||
5 | 90.9 (10/11) | 81.8 (9/11) | n.s | 72.7 (8/11) | 63.6 (7/11) | n.s | ||
PPV, % | 1 | 87.5 (7/8) | 87.5 (7/8) | NA | 87.5 (7/8) | 87.5 (7/8) | NA | |
2 | 100 (7/7) | 100 (7/7) | NA | 100 (7/7) | 100 (7/7) | NA | ||
3 | 85.7 (6/7) | 85.7 (6/7) | NA | 85.7 (6/7) | 85.7 (6/7) | NA | ||
4 | 100 (7/7) | 100 (6/6) | NA | 100 (7/7) | 100 (7/7) | NA | ||
5 | 87.5 (7/8) | 71.4 (5/7) | NA | 70.0 (7/10) | 60.0 (6/10) | NA | ||
NPV, % | 1 | 100 (10/10) | 100 (10/10) | NA | 100 (10/10) | 100 (10/10) | NA | |
2 | 100 (11/11) | 100 (11/11) | NA | 100 (11/11) | 100 (11/11) | NA | ||
3 | 90.9 (10/11) | 90.9 (10/11) | NA | 90.9 (10/11) | 90.9 (10/11) | NA | ||
4 | 100 (11/11) | 91.7 (11/12) | NA | 100 (11/11) | 100 (11/11) | NA | ||
5 | 100 (10/10) | 81.8 (9/11) | NA | 100 (8/8) | 87.5 (7/8) | NA | ||
Accuracy, % | 1 | 94.4 (17/18) | 94.4 (17/18) | n.s | 94.4 (17/18) | 94.4 (17/18) | n.s | |
2 | 100 (18/18) | 100 (18/18) | n.s | 100 (18/18) | 100 (18/18) | n.s | ||
3 | 88.9 (16/18) | 88.9 (16/18) | n.s | 88.9 (16/18) | 88.9 (16/18) | n.s | ||
4 | 100 (18/18) | 94.4 (17/18) | n.s | 100 (18/18) | 100 (18/18) | n.s | ||
5 | 94.4 (17/18) | 77.8 (14/18) | n.s | 83.3 (15/18) | 72.2 (13/18) | n.s | ||
AUC | 1 | 0.95 | 0.99 | n.s | 0.95 | 0.96 | n.s | |
2 | 1.00 | 1.00 | n.s | 1.00 | 1.00 | n.s | ||
3 | 0.88 | 0.88 | n.s | 0.89 | 0.89 | n.s | ||
4 | 1.00 | 1.00 | n.s | 1.00 | 1.00 | n.s | ||
5 | 0.97 | 0.79 | n.s | 0.94 | 0.88 | n.s |
Criteria | DWI1000 | DWI2000 |
---|---|---|
Total cases with DWI score 3 in long TR | 43/360 (11.9%) | 26/360 (7.2%) |
Short TR - upgrade to DWI score 4 | 12/43 (27.9%) | 4/26 (15.4%) |
Short TR - downgraded to DWI score 2 | 9/43 (20.9%) | 7/26 (26.9%) |
Short TR - same DWI score count | 22/43 (51.2%) | 15/26 (57.7%) |
Short TR - accuracy (upgraded) | 11/12 (91.7%) | 5/7 (71.4%) |
Short TR - accuracy (downgraded) | 8/9 (88.9%) | 2/4 (50%) |