Histogram analysis of stretched-exponential and monoexponential diffusion-weighted imaging models for distinguishing low and intermediate/high gleason scores in prostate carcinoma

BackgroundNoninvasive measures to evaluate the aggressiveness of prostate carcinoma (PCa) may benefit patients. PurposeTo assess the value of stretched-exponential and monoexponential diffusion-weighted imaging (DWI) for predicting the aggressiveness of PCa. Study TypeRetrospective study. SubjectsSeventy-five patients with PCa. Field Strength3T DWI examinations were performed using b-values of 0, 500, 1000, and 2000 s/mm(2). AssessmentThe research were based on entire-tumor histogram analysis and the reference standard was radical prostectomy. Statistical TestsThe correlation analysis was programmed with Spearman's rank-order analysis between the histogram variables and Gleason grade group (GG). Receiver operating characteristic (ROC) regression was used to analyze the ability of these histogram variables to differentiate low-grade (LG) from intermediate/high-grade (HG) PCa. ResultsThe percentiles and mean of apparent diffusion coefficient (ADC) and distributed diffusion coefficient (DDC) were correlated with GG (: 0.414-0.593), while there was no significant relation among value, skewnesses, and kurtosises with GG (:0.034-0.323). HG tumors (ADC:484136, 592139, 670144, 788146, 895 +/- 141mm(2)/s; DDC: 410 +/- 142, 532 +/- 172, 666 +/- 193, 786 +/- 196, 914 +/- 181mm(2)/s) had lower values in the 10(th), 25(th), 50(th), 75(th) percentiles and means than LG tumors (ADC: 644 +/- 779, 737 +/- 84, 836 +/- 83, 919 +/- 82, 997 +/- 107mm(2)/s; DDC: 552 +/- 82, 680 +/- 94, 829 +/- 112, 931 +/- 106, 1045 +/- 100mm(2)/s). However, there was no difference between LG and HG tumors in value (0.671 +/- 0.041 vs. 0.633 +/- 0.114), kurtosises (ADC 0.09 vs. 0.086; DDC -0.033 vs. -0.317), or skewnesses (ADC -0.036 vs. 0.073; DDC -0.063 vs. 0.136). The above statistics were P<0.01. ADC10 with AUC=0.840 and DDC10 with AUC=0.799 were similar in discriminating between LG and HG PCa at P<0.05. Data ConclusionHistogram variables of DDC and ADC may predict the aggressiveness of PCa, while value does not. The abilities of ADC10 and DDC10 to discriminate LG from HG tumors were similar, and both better than their respective means. Level of Evidence: 3 Technical Efficacy: Stage 1 J. MAGN. RESON. IMAGING 2018;48:491-498.