Prostate cancer: Utility of fusion of T2-weighted and high b-value diffusion-weighted images for peripheral zone tumor detection and localization

✍ Scribed by Andrew B. Rosenkrantz; Lorenzo Mannelli; Xiangtian Kong; Ben E. Niver; Douglas S. Berkman; James S. Babb; Jonathan Melamed; Samir S. Taneja

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 146 KB
• Volume: 34
• Category: Article
• ISSN: 1053-1807
• DOI: 10.1002/jmri.22598

✦ Synopsis

Abstract

Purpose:

To retrospectively assess the utility of fusion of T2‐weighted images (T2WI) and high b‐value diffusion‐weighted images (DWI) for prostate cancer detection and localization.

Materials and Methods:

In this IRB‐approved HIPAA‐compliant study, 42 patients with prostate cancer underwent MRI including multiplanar T2WI and axial DWI before prostatectomy. Two independent radiologists first assessed multiplanar T2WI and axial DWI~b‐1000~ images and recorded whether tumor was present in each sextant. Axial T2WI was then fused with axial DWI~b‐1000~ images, and the radiologists re‐evaluated each sextant for tumor. Accuracy was compared using generalized estimating equations based on a binary logistic regression model.

Results:

The accuracy, sensitivity, specificity, PPV, and NPV for tumor detection on a sextant‐basis using separate and fused image sets was 65.1%, 50.8%, 78.0%, 67.8%, and 63.6% and 71.0%, 60.8%, 80.3%, 73.7%, and 69.3%, respectively, for reader 1, and 54.0%, 42.5%, 64.4%, 52.0%, and 55.2%, and 61.1%, 56.7%, 65.2%, 59.6%, and 62.3%, respectively, for reader 2. The improvements in accuracy, sensitivity, and NPV using fused images were statistically significant for both readers, as was the improvement in PPV for reader 2 (P ranging from <0.0001 to 0.041). With either separate or fused images, there was greater sensitivity for tumors of higher grade or larger size (P ranging from <0.001 to 0.099).

Conclusion:

Fusion of T2WI and high b‐value DWI resulted in significant improvements in sensitivity and accuracy for tumor detection on a sextant‐basis, with similar specificity. J. Magn. Reson. Imaging 2011;. © 2011 Wiley‐Liss, Inc.