• Yingchan Shan, Xiaoshan Chen, Kai Liu, Mengsu Zeng, and Jianjun Zhou.
• Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Medical Imaging, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
• Abdom Radiol (NY). 2019 Oct 1; 44 (10): 3441-3452.

PurposeTo explore the preponderant diagnostic performances of IVIM and DKI in predicting the Gleason score (GS) of prostate cancer.MethodsDiffusion-weighted imaging data were postprocessed using monoexponential, lVIM and DK models to quantitate the apparent diffusion coefficient (ADC), molecular diffusion coefficient (D), perfusion-related diffusion coefficient (Dstar), perfusion fraction (F), apparent diffusion for Gaussian distribution (Dapp), and apparent kurtosis coefficient (Kapp). Spearman's rank correlation coefficient was used to explore the relationship between those parameters and the GS, Kruskal-Wallis test, and Mann-Whitney U test were performed to compare the above parameters between the different groups, and a receiver-operating characteristic (ROC) curve was used to analyze the differential diagnosis ability. The interpretation of the results is in view of histopathologic tumor tissue composition.ResultsThe area under the ROC curves (AUCs) of ADC, F, D, Dapp, and Kapp in differentiating GS ≤ 3 + 4 and GS > 3 + 4 PCa were 0.744 (95% CI 0.581-0.868), 0.726 (95% CI 0.563-0.855), 0.732 (95% CI 0.569-0.860), and 0.752 (95% CI 0.590-0.875), 0.766 (95% CI 0.606-0.885), respectively, and those in differentiating GS ≤ 7 and GS > 7 PCa were 0.755 (95% CI 0.594-0.877), 0.734 (95% CI 0.571-0.861), 0.724 (95% CI0.560-0.853), and 0.716 (95% CI 0.552-0.847), 0.828 (95% CI 0.676-0.929), respectively. All the P values were less than 0.05. There was no significant difference in the AUC for the detection of different GS groups by using those parameters.ConclusionBoth the IVIM and DKI models are beneficial to predict GS of PCa and indirectly predict its aggressiveness, and they have a comparable diagnostic performance with each other as well as ADC.

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