The evaluation of prostate lesions with IVIM DWI and MR perfusion parameters at 3T MRI

Radiol Med. 2019 Feb;124(2):87-93. doi: 10.1007/s11547-018-0930-3. Epub 2018 Oct 1.

Abstract

Purpose: The purpose of our study was to analyze the difference between IVIM DWI and perfusion parameters of malignant lesions and benign lesions-normal prostate tissue.

Methods: This prospective study included 31 patients who had multiparametric prostate MRI with IVIM DWI due to elevated prostate-specific antigen level and clinical suspicion between February 2015 and September 2016.

Results: For peripheral zone, the mean values of Ktrans, Kep, iAUC, χ2 and f were significantly higher in malignant lesions, and the mean values of Dt were significantly lower in malignant lesions (p 0.00, p 0.02, p 0.00, p 0.02 and p 0.00, respectively). For transitional zone, the mean values of Ktrans, Ve, iAUC, χ2 and f were significantly higher in malignant lesions, and the mean values of Dp and Dt were significantly lower in malignant lesions (p 0.00, p 0.00, p 0.00, p 0.00, p 0.00, p 0.02 and p 0.00, respectively). For whole prostate gland, the mean values of Ktrans, Kep, Ve, iAUC, χ2 and f were significantly higher in malignant lesions, and the mean values of Dp and Dt were significantly lower in malignant lesions (p 0.00, p 0.03, p 0.00, p 0.00, p 0.00, p 0.01, p 0.04 and p 0.00, respectively).

Conclusions: Restricted diffusion-pseudodiffusion and increased perfusion parameters are important to differentiate prostate cancer from benign pathologies. It is also important to keep in mind that transitional zone and peripheral zone tumors may have different perfusion and diffusion parameters. Future studies are needed to confirm our findings.

Keywords: IVIM; Magnetic resonance imaging; Perfusion; Prostate lesion.

MeSH terms

  • Aged
  • Contrast Media
  • Diagnosis, Differential
  • Diffusion Magnetic Resonance Imaging
  • Humans
  • Image Enhancement / methods
  • Image Interpretation, Computer-Assisted / methods
  • Image-Guided Biopsy
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Prospective Studies
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms / diagnostic imaging*
  • Prostatic Neoplasms / pathology
  • Sensitivity and Specificity

Substances

  • Contrast Media
  • Prostate-Specific Antigen