Dynamic contrast enhanced MRI Pharmacokinetic parameter histogram analysis in diagnosis of malignant prostatic lesions

Background : To differentiate prostate cancer and benignprostatichyperplasia by WAHPP (the whole lesion histogram analysis of the pharmacokineticparameters) of dynamic contrast - enhancedMRI (DCE - MRI). Materials and Methods : Totally 62 patients with elevated prostate specific antigen (PSA) (> 4 ng/ml) were grouped as prostate cancer (PCa) group (n=33) and benign prostatic hyperplasia (BPH) group (n=29) based on transrectal ultrasound (TRUS) - guided random biopsy diagnosis and their WAHPP - K trans (constant is transferred from the blood plasma to the extracellular extravascular (EE) space), K ep (back into blood plasma at a steady rate from EE space), V e (EE volume fraction) and V p (fractional blood plasma volume) were compared. Results : WHAPP shows the 5th percentile and entropy of K trans, 5 th /10 th /25 th /50 th /75 th /90 th /95 th percentiles, mean value and entropy of K ep , 5 th percentile and uniformity of V e , 5 th /10 th /25 th /50 th /75 th percentiles, V p had a considerably greater mean value and entropy in PCa than in BPH (p0.05). The 90th percentile of Kep's maximum AUC (area under the curve) was 0.764, according to receiver operating characteristic (ROC) study, the Youden index 0.5507, the sensitivity 75.76%, and the specificity 79.31%. Conclusion : K trans , K ep , and V e of WHAPP canbe used to quantify prostate DCE - MRI. The 90 th percentile of K ep possibly will be the best indicator for the differential diagnosis of malignant and BPH.