• Xiaohang Liu, Weijun Peng, Liangping Zhou, and He Wang.
• Department of Radiology, Fudan University Shanghai Cancer Center, Shanghai 200032, China.
• Korean J Radiol. 2013 Mar 1; 14 (2): 222-32.

ObjectiveTo investigate the biexponential apparent diffusion parameters of diverse prostate tissues and compare them with monoexponential apparent diffusion coefficient (ADC) value in the efficacy to discriminate prostate cancer from benign lesions.Materials And MethodsEleven healthy volunteers and 61 patients underwent a conventional (b-factors 0, 1000 s/mm(2)) and a 10 b-factor (0 to 3000 s/mm(2)) diffusion-weighted imaging (DWI). The monoexponential ADC value and biexponential parameters of fast ADC (ADCf), fraction of ADCf (f), slow ADC (ADCs) value for 29 prostate cancer, 28 benign prostatic hyperplasia (BPH), 24 prostatitis lesions and normal tissue were calculated and compared. Receiver operating characteristic analysis was performed to determine the sensitivity, specificity and optimal cut-off points.ResultsProstate cancer had lower ADC, ADCf, f, and ADCs than all other tissues (p < 0.01). Prostatitis exhibited a lower ADC, ADCf, ADCs and f than the peripheral zone tissue (p < 0.01), and BPH showed a lower ADC and ADCf than the central gland tissue (p < 0.01). The ADCf demonstrated a comparable accuracy with ADC in differentiating cancer from BPH [area under the curve (AUC) 0.93 vs. 0.92] and prostatitis AUC 0.98 vs. 0.99) (both p > 0.05), but the AUC of f and ADCs in differentiating cancer from BPH (0.73 and 0.81) and prostatitis (0.88 and 0.91) were significantly lower than ADC (all p < 0.05).ConclusionThe biexponential DWI appears to provide additional parameters for tissue characterization in prostate, and ADCf helps to yield comparable accuracy with ADC in differentiating cancer from benign lesions.

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