Performance of Diffusion Kurtosis Imaging Versus Diffusion Tensor Imaging in Discriminating Between Benign Tissue, Low and High Gleason Grade Prostate Cancer

Trani, Maria Giovanna Di; Nezzo, Marco; Caporale, Alessandra; Feo, Riccardo De; Miano, Roberto; Mauriello, Alessandro; Bove, Pierluigi; Manenti, Guglielmo; Capuani, Silvia

doi:10.1016/j.acra.2018.11.015

Cited by 15 publications

(7 citation statements)

References 43 publications

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“…A distinctive feature of our study is the consistent utilization of multiparametric magnetic resonance imaging (mpMRI) as an imaging tool throughout the follow-up period, which distinguishes it from previous research in this field. The use of mpMRI as the primary follow-up imaging method resulted in high accuracy for the validation of the procedure [25][26][27].…”

Section: Discussionmentioning

confidence: 99%

TransPerineal Laser Ablation (TPLA) Treatment of Focal Low-Intermediate Risk Prostate Cancer

Manenti,

Perretta,

Nezzo

et al. 2024

Preprint

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Background: this interventional pilot study aimed to evaluate the short-term (3 years) efficacy of focal laser ablation (FLA) in treating the index lesion of low-intermediate risk prostate cancer, along with assessing the safety of the procedure (ClinicalTrials.gov ID NCT04045756). Methods: forty patients aged between 46 and 86 with histologically proven organ-confined prostate cancer and low to intermediate progression risk were included. FLA was performed under percutaneous fusion magnetic resonance/ultrasound guidance in a Day Hospital setting under local anesthesia. Patients underwent regular clinical assessments, PSA measurements, post-procedure MRI scans, and biopsies at 36 months or if positive findings were detected earlier. Statistical analyses were conducted to assess trends in PSA levels and cavity dimensions over time. Results: forty patients were initially included, with 15 lost to follow-up. At 36 months, a mean PSA reduction of 60% was observed, and 80% of MRI scans showed no signs of in-field clinically significant residual/recurrent cancer. Biopsies at 36 months revealed no malignant findings in 20 patients. No deterioration in sexual function or urinary symptoms was recorded. Conclusions: FLA appears to be safe, feasible and effective in the index lesion treatment of low-intermediate risk prostate cancer, with a high rate of tumor eradication and preservation of quality of life.

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Section: Discussionmentioning

confidence: 99%

TransPerineal Laser Ablation (TPLA) Treatment of Focal Low-Intermediate Risk Prostate Cancer

Manenti,

Perretta,

Nezzo

et al. 2024

Preprint

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“…We conjecture that the decrease in CR in DTI-maps obtained using b-value ranges 0–2000 and 0–2500 s/mm 2 compared to narrower b-value ranges was due to the mono-exponential diffusion model adopted here. Indeed, it is well known that in biological tissues, the signal decay associated with water diffusion deviates from the mono-exponential behavior at b-values higher than approximately 1500 s/mm 2 , and it would be consequently better described by non-Gaussian diffusion models, such as the Kurtosis [ 37 , 38 , 39 ].…”

Section: Discussionmentioning

confidence: 99%

“…Another substantial difference between normal and neoplastic cells is the presence of prominent nucleoli (with a diameter > 1 µm) in the latter [ 25 ]. However, to make water displacements sensitive to such a difference, it would be necessary to increase considerably the b-value (up to b = 5000 s/mm 2 ), adopting non-Gaussian diffusion models [ 39 , 58 ] or anomalous diffusion models [ 59 , 60 , 61 , 62 , 63 ]. Other strategies to improve the discriminative power of diffusion parameters consider the exploitation of both the diffusion and relaxation properties of tissue compartments, such as in a recently developed biophysical model, called rVERDICT, which allows to obtain MRI parameters with enhanced sensitivity and specificity with respect to the cancer-related tissue modifications [ 64 ].…”

Section: Discussionmentioning

confidence: 99%

Acquisition Parameters Influence Diffusion Metrics Effectiveness in Probing Prostate Tumor and Age-Related Microstructure

Caporale

Nezzo

Trani

et al. 2023

JPM

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This study aimed to investigate the Diffusion-Tensor-Imaging (DTI) potential in the detection of microstructural changes in prostate cancer (PCa) in relation to the diffusion weight (b-value) and the associated diffusion length lD. Thirty-two patients (age range = 50–87 years) with biopsy-proven PCa underwent Diffusion-Weighted-Imaging (DWI) at 3T, using single non-zero b-value or groups of b-values up to b = 2500 s/mm2. The DTI maps (mean-diffusivity, MD; fractional-anisotropy, FA; axial and radial diffusivity, D// and D┴), visual quality, and the association between DTI-metrics and Gleason Score (GS) and DTI-metrics and age were discussed in relation to diffusion compartments probed by water molecules at different b-values. DTI-metrics differentiated benign from PCa tissue (p ≤ 0.0005), with the best discriminative power versus GS at b-values ≥ 1500 s/mm2, and for b-values range 0–2000 s/mm2, when the lD is comparable to the size of the epithelial compartment. The strongest linear correlations between MD, D//, D┴, and GS were found at b = 2000 s/mm2 and for the range 0–2000 s/mm2. A positive correlation between DTI parameters and age was found in benign tissue. In conclusion, the use of the b-value range 0–2000 s/mm2 and b-value = 2000 s/mm2 improves the contrast and discriminative power of DTI with respect to PCa. The sensitivity of DTI parameters to age-related microstructural changes is worth consideration.

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“…In prostate cancer, FA and MD vary because of altered diffusivity and disorganization of the fibers. (MD) has been used to describe the strength of diffusion in biological tissues which is valid only for homogeneous fluid with free diffusion, diffusion can be hindered or restricted, and result in decreased MD [21].…”

Section: Discussionmentioning

confidence: 99%

Diagnostic utility of three Tesla diffusion tensor imaging in prostate cancer: correlation with Gleason score values

Abouelkheir

Aboshamia

Taman

2022

Egypt J Radiol Nucl Med

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Background Preoperative assessment of prostate cancer (PCa) aggressiveness is a prerequisite to provide specific management options. The Gleason score (GS) obtained from prostatic biopsy or surgery is crucial for the evaluation of PCa aggressiveness and personalized treatment planning. Diffusion tensor imaging (DTI) provides valuable information about microstructural properties of prostatic tissue. The most common prostate DTI measures are the fractional anisotropy (FA) and median diffusivity (MD) can give more information regarding the biophysical characteristics of prostate tissue. We aimed to explore the correlation of these DTI parameters with GS levels in PCa patients that can affect the management protocol of PCa. Results The computed area under curve (AUC) of the FA values used to differentiate cancer patients from control group was (0.90) with cutoff point to differentiate both groups were ≥ 0.245. The computed sensitivity, specificity, positive and negative predictive values were (84%, 80%, 95.5%, and 50%), respectively, with accuracy 83.3%. FA showed high positive correlation with Gleason score (p value < 0.001). Median diffusivity (MD) showed negative correlation with GS with statistically significant results (p value = 0.013). PCa fiber bundles were dense, orderly arranged, without interruption in the low grade, and slightly disorganized in the intermediate group. However, in the high-grade group, the fiber bundles were interrupted, irregularly arranged, and absent at the site of cancerous foci. Conclusions Combined quantitative parameter values (FA and MD values) and parametric diagrams (FA and DTI maps) can be utilized to evaluate prostate cancer aggressiveness and prognosis, helping in the improvement of the management protocol of PCa patients.

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Performance of Diffusion Kurtosis Imaging Versus Diffusion Tensor Imaging in Discriminating Between Benign Tissue, Low and High Gleason Grade Prostate Cancer

Cited by 15 publications

References 43 publications

TransPerineal Laser Ablation (TPLA) Treatment of Focal Low-Intermediate Risk Prostate Cancer

TransPerineal Laser Ablation (TPLA) Treatment of Focal Low-Intermediate Risk Prostate Cancer

Acquisition Parameters Influence Diffusion Metrics Effectiveness in Probing Prostate Tumor and Age-Related Microstructure

Diagnostic utility of three Tesla diffusion tensor imaging in prostate cancer: correlation with Gleason score values

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