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Jochen Bauer¹, Maria Eveslage², and Benjamin Noto^1
1Department of Clinical Radiology, University of Muenster, Münster, Germany, ²Institute of Biostatistics and Clinical Research, University of Muenster, Muenster, Germany

Keywords: Prostate, Diffusion/other diffusion imaging techniques, lymph node, reproducibility

Apparent diffusion coefficient (ADC) has potential as a quantitative imaging biomarker for differentiation of malignant from benign tissue. Here, we present a phantom and in vivo measurement of ADC reproducibility and a restrospective study in over 100 patients with prostate cancer to evaluate ADC as a classifier.

Kangwen He¹, Xiaoyan Meng¹, and Zhen Li^1
1Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China

Keywords: Prostate, Cancer, high-risk prostate cancer, biochemical recurrence

直方图分析是医学图像的定量后处理方法，被认为在癌症管理中很有价值。我们使用表观扩散系数 (ADC) 图的直方图参数分析了在根治性前列腺切除术 (RP) 后接受辅助激素治疗 (AHT) 的高危前列腺癌 (PCa) 患者的结果。我们观察到，较低的 ADC ₅₀ 和较高的峰度可以独立预测较差的生化无复发生存期 (BCR-fs)，并且当添加直方图参数时，预后模型的性能会有所提高。我们的研究结果显示了 ADC 直方图分析在这一特定的 PCa 患者亚组中的增量预后价值。

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Atsushi Nakamoto¹, Hiromitsu Onishi¹, Takahiro Tsuboyama¹, Takashi Ota¹, Hideyuki Fukui¹, Keigo Yano¹, Kengo Kiso¹, Toru Honda¹, Shohei Matsumoto¹, Mitsuaki Tatsumi¹, Hiroyuki Tarewaki², Yoshihiro Koyama², Tetsuya Wakayama³, Xinzeng Wang⁴, and Noriyuki Tomiyama^1
1Osaka University Graduate School of Medicine, Suita, Japan, ²Osaka University Hospital, Suita, Japan, ³GE Healthcare, Hino, Japan, ⁴GE Healthcare, Houston, TX, United States

Keywords: Prostate, Image Reconstruction, Deep learning reconstruction

The image quality of high-resolution PROPELLER T2WI combined with deep learning reconstruction (DLR) in prostate MRI was evaluated by the phantom and clinical studies. In the phantom study, noise reduction was achieved by DLR, and spatial resolution was remarkably improved in PROPELLER T2WI compared to Cartesian T2WI. In the clinical study, DLR showed a significant improvement in signal-to-noise ratio, and the qualitative analyses showed reduced image noise and improved spatial resolution, with PROPELLER T2WI DLR images showing the highest overall image quality. PROPELLER T2WI with DLR would be promising technique to improve the image quality of T2WI in prostate MRI.

Xiwei Li¹, Lihua Chen¹, Nan Wang¹, Liangjie Lin², Jiazheng Wang², and Ailian Liu^1
1The First Affiliated Hospital of Dalian Medical University, Dalian, China, ²Philips Healthcare,Beijing, Beijing, China

Keywords: Cancer, Prostate

At present, the prostate specific antigen (PSA) detection is a common method for screening prostate cancer. However, the specificity of PSA is very low, and it is easy to appear false positive. In recent years, multiparameter imaging has great value in the diagnosis of prostate diseases. Amide proton weighted（APTw） imaging and T1 mapping imaging can more accurately reflect the information of tumor tissue cell metabolism and pathological cell microstructure.The purpose of this study was to evaluate the value of  APT and  T1 measurements in the diagnosis of prostate cancer and benign prostatic hyperplasia.

Kun-Peng Zhou¹, Jie Bian², Hua-Bin Huang¹, Chao Bu¹, and Li-Zhi Xie^3
1Radiology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China, ²Radiology, the second hospital of dalian medical university, dalian, China, ³GE Healthcare, Beijing, China, Beijing, China

Keywords: Prostate, Prostate

The aim of this study was to investigate the use of advanced diffusion-weighted imaging (IVIM, stretched exponential model and DKI) to sub-differentiation of TZ PI-RADS 3 lesions and aid the biopsy decision process. Finally, the logistic model could correctly classify 89.39% of the subjects. The results of ROC analysis showed that AUC was 0.9197, CI 95%: 0.8736-0.9659. Sensitivity, specificity, positive predictive value and negative predictive value were 92.1%, 80.4%, 93.9% and 75.5%, respectively. Therefore, advanced diffusion-weighted imaging can predict PCa in TZ PI-RADS 3 lesions and inform the decision-making process of whether or not to perform a biopsy.

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Haoran Sun^1,2, Lixia Wang¹, Timothy Daskivich³, Shihan Qiu^1,2, Fei Han¹, Alessandro D'Agnolo⁴, Rola Saouaf⁵, Hyung Kim³, Debiao Li^1,2, and Yibin Xie^1
1Biomedical Imaging Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States, ²Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States, ³Minimally Invasive Urology, Cedars-Sinai Medical Center, Los Angeles, CA, United States, ⁴Imaging/Nuclear Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States, ⁵Imaging, Cedars-Sinai Medical Center, Los Angeles, CA, United States

Keywords: Prostate, Quantitative Imaging

Prostate cancer (PCa) is one of the most common types of cancer with a considerable morbidity and mortality. Multiparametric MRI as a noninvasive imaging tool in PCa diagnosis has limitations. Recent studies suggest that quantitative T2 information is helpful in PCa diagnosis and lesion characterization but is not generally available due to the need for additional scans. Here, we developed a DL-based method to estimate T2 maps retrospectively from clinically acquired T1- and T2-weighted images. The developed technique has the potential to improve PCa diagnosis and lesion characterization using quantitative T2 information estimated from conventional clinical scans.

Zhaonan Sun¹, Xiaoying Wang², and Kexin Wang^3
1Department of Radiology, Peking University First Hospital, Beijing, China, ²Department of Radiology, Peking University First Hospital, Beijing, China, ³School of Basic Medical Sciences, Capital Medical University, Beijing, China

Keywords: Prostate, Cancer

The purpose of this study was to explore the best sequences for fully automated detection and localization of early-stage csPCa with a PSA range of 4-10 ng/mL.1628 prostate mpMRI examined with seven scanners were retrospectively enrolled. A training dataset (n=1428) was used to train models, i.e., a diffusion model was trained with diffusion-weighted imaging, and a biparametric model was trained with diffusion-weighted imaging and T2-weighted imaging. A hold-out test dataset (n=200) was reserved for validation. Our research shows that the diffusion model trained using ADC and DWI achieved best performance in detection and localization of early-stage csPCa.

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Zachary Franks¹, Jarrett Rosenberg¹, Richard E. Fan¹, Geoffrey Sonn¹, and Pejman Ghanouni^1
1Stanford Health Care, Stanford, CA, United States

Keywords: Prostate, Cancer

Prostate Imaging Reporting and Data System (PIRADS) guidelines are used as a standard to help radiologists diminish variation in the acquisition, interpretation, and reporting of multiparametric magnetic resonance imaging (mpMRI) for prostate cancer diagnosis. However, the performance of mpMRI has been shown to vary across radiologists. A retrospective study was performed at a tertiary care center to assess the range of positive predictive values (PPV) across individual radiologists interpreting mpMRI in detecting any prostate cancer compared to targeted MR-US guided fusion biopsy pathology results.

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Yu Ueda¹, Tsutomu Tamada², Ayumu Kido², Kazunori Moriya², Shigeru Shibata², Mitsuru Takeuchi³, Akira Yamamoto², Makoto Obara¹, and Marc Van Cauteren^4
1Philips Japan, Ltd., Tokyo, Japan, ²Department of Radiology, Kawasaki Medical School, Kurashiki, Japan, ³Department of Diagnostic Radiology, Radiolonet Tokai, Nagoya, Japan, ⁴Philips Healthcare, Business Unit MR, Tokyo, Japan

Keywords: Prostate, Quantitative Imaging

It has been reported that synthetised DW images with short TR and zero TE, generated from quantitative relaxation parameters, improved lesion contrast in prostate. In this study, we investigate the added value of the estimated T1 and T2 values in differentiating benign from malignant lesion in suspicious cancers with PI-RADS category 3, potentially reducing unnecessary biopsies. In addition to the conventional DW images at b-values of 1000 and 2000, ADC map, and estimated T1 and T2 maps, synthetised DW images can be acquired in approximately 4 minutes, an acceptable scan time in clinical practice.

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Sudhanya Chatterjee¹, Dattesh Dayanand Shanbhag¹, Aanchal Mongia¹, Uday Patil¹, Adele Courot², Nicolas Gogin², and Rakesh Mullick^1
1GE Healthcare, Bangalore, India, ²GE Healthcare, Buc, France

Keywords: Prostate, Cancer, DWI, ADC, Gleason grade

Diffusion weighted MRI (DWI) derived apparent diffusion coefficient (ADC) is a marker of the extent of restrictive diffusion in tissues. Higher Gleason Grade (GG) prostate cancer (PCa) lesions are known to exhibit higher restrictive diffusion. In this study we investigated whether ADC as a tissue biomarker follows the known histopathological behavior of PCa lesions by studying variations in ADC with respect to GG of PCa lesions and its location. We observe that ADC values of lesion voxels, although belonging to same GG, vary based on its location.

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Yannik Christian Layer¹, Petra Muertz¹, Leon Bischoff¹, Christoph Katemann², Kilian Weiss², Julian Luetkens¹, Ulrike Attenberger¹, and Claus Christian Pieper^1
1Department of Diagnostic and Interventional Radiology, University Hospital Bonn, Bonn, Germany, ²Philips GmbH Market DACH, Hamburg, Germany

Keywords: Prostate, Tumor

The aim of this single-center, prospective study was to evaluate an accelerated diffusion-weighted imaging sequence of the prostate using Echo Planar Imaging with Compressed SENSE based reconstruction and assess its performance in comparison to conventional DWI. The evaluated sequences considerably reduced the total DWI acquisition time by 43% and achieved overall good image quality without significant differences compared to the conventional DWI sequence. The reduced scan time allows for an increase of the overall number of scanned patients as well as increased patient convenience with less potential of motion artifacts and therefore benefits care of patients with suspected prostate cancer.

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Yanling Chen¹, Huanjun Wang ¹, and Yan Guo^1
1Department of Radiology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China

Keywords: Prostate, Diffusion/other diffusion imaging techniques

The current study investigated the qualitative and quantitative image quality of three DWI sequences of the prostate: SS DWI, MUSE DWI and a new DWI sequence named FOCUS-MUSE DWI. Twenty-three healthy volunteers were enrolled. The diagnostic image quality score was assessed by two radiologists on the three DWI sequences. And the ADC values in the peripheral and transitional zone were measured together with the Dice Coefficient calculated for quantitative comparison. Our results indicated that FOCUS-MUSE DWI had a superior image quality and more stable ADC measurement compared with SS DWI and MUSE DWI. The geometric distortion level was also reduced.

Kun-Peng Zhou¹, Hua-Bin Huang¹, Long Liu¹, Jie Bian², and Li-Zhi Xie^3
1Radiology, The Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, China, ²Radiology, The second hospital of Dalian medical university, Dlian, China, ³GE Healthcare, Beijing, Beijing, China

Keywords: Prostate, Prostate

The aim of this study was to investigate the use of advanced diffusion-weighted imaging to sub-differentiation of intermediate risk group PCa and aid treatment decision process. Finally, the logistic model was statistically significant, χ2=90.969, p<0.001. The model could correctly classify 86.40% of the subjects. The results of ROC analysis showed that area AUC was 0.9429, CI 95%: 0.9054-0.9805. Sensitivity, specificity, positive predictive value and negative predictive value were 88.06%, 84.31%, 88.06% and 84.31%, respectively. The results of this research may indicate that advanced diffusion-weighted imaging can sub-differentiate intermediate risk group PCa and aid the decision process of treatment.

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Rudy Rizzo^1,2, Angeliki Stamatelatou³, Kadir Simsek⁴, Jack J.A. Van Asten³, Roland Kreis^1,2, Arend Heerschap³, and Tom Scheenen^3
1Magnetic Resonance Methodology, Institute of Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland, ²Translational Imaging Center (TIC), Swiss Institute for Translational and Entrepreneurial Medicine, Bern, Switzerland, ³Department of Medical Imaging, Radboud University Medical Center, Nijmegen, Netherlands, ⁴Cardiff University Brain Research Imaging Centre (CUBRIC), Cardiff University, Cardiff, United Kingdom

Keywords: Prostate, Cancer

Prostate pathologies like cancer and prostatitis cause alterations in tissue microstructure that are reflected in signal variations on diffusion-weighted MRI or MR relaxometry. Diffusion-weighted MR Spectroscopy (DW-MRS) allows specific characterization of tissue microstructure by quantifying both concentration and diffusion properties of MR-observable metabolites. In this work, an optimized DW-MRS protocol tailored to overcome the inherent challenges of prostate measurements is deployed. Initial results on potential alterations of metabolite concentrations and diffusivities (ADCs) are reported for prostate cancer and prostatitis. The preliminary findings are tentatively explained by microstructure alterations of the prostate tissue.

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Takahiro Ueda¹, Yoshiharu Ohno^1,2, Maiko Shinohara³, Kaori Yamamoto³, Masato Ikedo³, Masao Yui³, Akiyoshi Iwase⁴, Minami Furuta¹, Yuki Obama¹, Hiroyuki Nagata², Hirotaka Ikeda¹, Yoshiyuki Ozawa¹, and Hiroshi Toyama^1
1Radiology, Fujita Health University School of Medicine, Toyoake, Japan, ²Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan, ³Canon Medical Systems Corporation, Otawara, Japan, ⁴Fujita Health University Hospital, Toyoake, Japan

Keywords: Prostate, Cancer

We hypothesize that RDC is useful for image quality and diagnostic performance improvements on DWI with b value at 1500 s/mm² in suspected prostatic cancer patients, although there was little influence of RDC on DWI at in vitro study.   The purpose of this study was to determine the influence of RDC for ADC measurement at in vitro study and its’ utility for improving image quality and diagnostic performance of malignant from benign prostatic areas on prostatic DWI as in vivo study.   

Qiqi Zhou¹, Weiyin Vivian Liu², Qian Tang³, Ling Sang¹, Wen Chen¹, and Lin Xu^1
1Department of Radiology,Taihe Hospital,Hubei University of Medicine, Hubei, China, ²GE Healthcare, MR Research, Beijing, China, ³Department of Biomedical Engineering,Hubei University of Medicine, Hubei, China

Keywords: Prostate, Cancer

High b-value diffusion weighted imaging is clinically challenging due to its inherently low SNR and prone to presence of severe eddy current distortion due to utility of large diffusion sensitization gradient, not to mentioned high-resolution prostate DWI .In our study, 5b-protocol rFOV-syDWIswith pros of short scan time provided better lesion clarity and higher image quality.Moreover, synthetic ADCs offered reliable and satisfactory diagnostic value as scanned 13b-protocol DWIs despite significant difference of mean and median were found between syADC_b=1500 and sADC_b=1500 in PCa but not in hyperplasia, indicating diagnosis withrFOV-syADCs should be careful when referring to rFOV-sADCs.

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TSUTOMU TAMADA¹, YUICHI KOJIMA¹, AYUMU KIDO¹, YU UEDA², MITSURU TAKEUCHI³, KENTARO ONO¹, MIDORI YAMAMOTO¹, AKIRA YAMAMOTO¹, and YOSHIHIKO FUKUKURA^1
1Radiology, Kawasaki Medical School, Kurashiki-city, Japan, ²Philips Japan, Tokyo, Japan, ³Radiology, Radiolonet Tokai, Nagoya, Japan

Keywords: Prostate, Prostate

We compared diagnostic performance of clinically significant PC (csPC) between calculated DWI (calDWI) which enable to synthesize DW images with any TR and TE and native acquired single-shot EPI DWI (nDWI). The calDWI was generated with TR of 1000 and TE of 0 ms. Three radiologists independently assessed eight regions of each prostate by PI-RADS v 2.1 DWI score. For diagnostic performance of csPC, AUC was comparable between calDWI and nDWI in two readers. The diagnostic specificity was significantly higher in calDWI than in nDWI in two readers. Compared with nDWI, calDWI had similar or higher diagnostic performance in csPC.

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Anne Adlung^1,2, Fabian Tollens³, Anika Strittmatter^1,2, Niklas Westhoff⁴, Daniel Hausmann⁵, Stefan O Schoenberg³, Lothar R Schad^1,2, Dominik Nörenberg³, and Frank G Zöllner^1,2
1Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany, ²Mannheim Institute for Intelligent Systems in Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany, ³Department of Radiology and Nuclear Medicine, Mannheim University Medical Centre, Mannheim, Germany, ⁴Department of Urology and Urosurgery, Mannheim University Medical Centre, Mannheim, Germany, ⁵Department of Radiology, Kantonsspital Baden, Baden, Switzerland

Keywords: Prostate, Tumor

Aim of this prospective study was to evaluate ²³Na MRI of 36 patients with suspected prostate cancer and quantify tissue sodium concentration (TSC) based on internal references. TSC reference regions were defined within both femoral blood vessels (FBV), where TSC showed no significant differences between both sides (3.3±2.2 mM, p=0.076). TSC in the prostate was 39.0±5.3 mM; significantly higher in the peripheral than in the transitional zone (p=0.0004, mean difference 4.7±3.5 mM). Nine lesions were segmented and showed mean TSC of 32.2±5.5, significantly lower than contralateral (p=0.0181). TSC might represent a quantitative biomarker that could improve prostate lesion characterization.

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Xiaomeng Qiao¹, Chenhan Hu¹, Jie Bao¹, Ximing Wang¹, Yang Song², and Yunzhu Wu^2
1Department of radiology, First Affiliated Hospital of Soochow University, Suzhou, China, ²MR Scientific Marketing, Siemens Healthineers Ltd, Shanghai, China

Keywords: Prostate, Radiomics, Clinically significant prostate cancer; Prostate-specific antigen

Radiomics was a promising method for csPCa with PSA levels in the gray zone and outperformed PI-RADS assessments.

Qiqi Zhou¹, Weiyin Vivian Liu², Qian Tang³, Ling Sang¹, Wen Chen¹, and Lin Xu^1
1Department of Radiology,Taihe Hospital,Hubei University of Medicine, Hubei, China, ²GE Healthcare, MR Research, Beijing, China, ³Department of Biomedical Engineering,Hubei University of Medicine, Hubei, China

Keywords: Prostate, Cancer

This study investigated the value of relaxation time in synthetic MRI imaging combined with intravoxel incoherent motion (IVIM) imaging in differentiating transitional zone prostate cancer from benign prostatic hyperplasia (BPH). Finally, it was found that T2 value in synthetic MRI imaging and D value in IVIM imaging had higher diagnostic sensitivity and specificity, and their combined diagnostic performance was higher. It is helpful for the differential diagnosis of BPH and PCa in transitional zone.