J Korean Soc Radiol.  2011 Feb;64(2):179-184. 10.3348/jksr.2011.64.2.179.

Value of Diffusion Tensor Imaging of Prostate Cancer: Comparison with Systemic Prostate Biopsy

• Yoon SK
• Kim DW
• Ha DH
• Kwon HJ
• Kang M
• Choi S
• Nam KJ
• Kim JI

• KMID: 2097935
• DOI: http://doi.org/10.3348/jksr.2011.64.2.179

Abstract

PURPOSE
This study was performed to evaluate the usefulness of diffusion tensor imaging (DTI) and to correlate systemic twelve biopsy in prostate cancer.
MATERIALS AND METHODS
Thirty-one patients with suspected prostate cancer underwent MR imaging. DTI was performed prior to a prostate biopsy. We prospectively calculated the apparent diffusion coefficient (ADC) and fractional anisotropy (FA) value in each corresponding biopsy site.
RESULTS
Twenty-three of 31 patients had histopathologically proven adenocarcinoma. Among the 276 biopsy cores of 23 patients with prostate cancer, 109 cores showed positive results (39%). The ADC and FA value of positive cores were 1.31 +/- 0.34x10(-3) mm2/s and 0.68 +/- 0.07, and those of the negative cores were 1.74 +/- 0.45x10(-3) mm2/s and 0.54 +/- 0.09, respectively. Eight patients without carcinoma showed an ADC value of 1.83 +/- 0.26x10(-3) mm2/s and an FA value of 0.47 +/- 0.07. The ADC and FA value of positive cores were significantly lower and higher than those of negative cores and cancer-free patients, respectively (p < 0.05).
CONCLUSION
The ADC and FA values using DTI may provide useful diagnostic information in the differentiation of cancerous tissues, although there is overlap in some cases.

MeSH Terms

Adenocarcinoma
Anisotropy
Biopsy
Diffusion
Diffusion Magnetic Resonance Imaging
Diffusion Tensor Imaging
Humans
Magnetic Resonance Imaging
Prospective Studies
Prostate
Prostatic Neoplasms

Figure

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  Fig. 1 T2-weighted image (A) shows low signal intensity (arrow) of the left peripheral zone in accordance with a positive biopsy result. We obtained b = 500 s/mm2 image (B) and isotropic image (C) using diffusion tensor imaging. The ADC (D) and FA (E) value shows corresponding decrease and increase in the same regions.

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  Fig. 2 Diagrams of the TRUS guided 12 biopsy site at the axial plane in 3 levels of the prostate glands (A-C).

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  Fig. 3 Receiver operating characteristics curve. Graph of the curve for ADC shows that the area under the curve is 0.914 for differentiating prostate cancer from non-cancerous tissue.

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  Fig. 4 Receiver operating characteristics curve. Graph of the curve for FA shows that the area under the curve is 0.983 for differentiating prostate cancer from non-cancerous tissue.

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