The value of ESWAN in diagnosis and differential diagnosis of prostate cancer: Preliminary study

Objective To evaluate the value of enhanced T2 star-weighted angiography (ESWAN) in diagnosis and differential diagnosis of prostate cancer by comparing the multiple indices of ESWAN in benign prostatic hyperplasia (BPH), prostate cancer (PCa) and the normal peripheral zone (PZ). Methods Traditional MRI and ESWAN were performed on forty-nine clinically-diagnosed PCa patients, sixty BPH patients, and forty-six normal adult males. The ESWAN indices (magnitude value, phase value, R2* value and T2* value) measured on different regions of interest (ROIs) were analyzed. Additionally, receiver operating characteristic (ROC) analysis was performed to obtain the area under the curve (AUC), sensitivity, specificity, and optimal cut-off points of PCa and BPH, PCa and PZ respectively. Results The magnitude value, phase value, R2* value and T2* value of PZ were 1529.43±254.43, 0.0689±0.1619, 16.57±8.11, 82.75±53.87, respectively; the magnitude value, phase value, R2* value, and T2* value of PCa were 1540.18±338.62, −0.0176±0.0919, 26.93±11.31, and 45.99±17.43, respectively; the magnitude value, phase value, R2* value, and T2* value of BPH were 1579.49±285.28, 0.0209±0.0839, 20.69±3.95, and 51.56±8.90, respectively. Compared with normal PZ, phase value of PCa was lower (t=−3.302, P=0.001), R2* value higher (t=5.326, P=0.000), and T2* value lower (t=−4.570, P=0.000); compared with BPH, phase value of PCa was lower (t=−2.261, P=0.026), R2* value higher (t=3.988, P=0.000), and T2* value lower (t=−2.155, P=0.033). When PCa and PZ were distinguished, the AUC of magnitude value, phase value, R2* value, and T2* value were respectively 0.539 (P=0.510), 0.679 (P=0.0007), 0.811 (P<0.0001), and 0.762 (P<0.0001); the diagnosis efficiency of R2* value was higher than that of T2* value (P=0.037), while the diagnosis efficiency of T2* value was equivalent to phase value (P=0.256). When PCa was differentiated from BPH, the AUC of magnitude value, phase value, R2* value, and T2* value were 0.518 (P=0.752), 0.612 (P=0.039), 0.705 (P=0.0001), and 0.685 (P=0.0006), respectively; there was no statistical difference in the diagnostic efficiency of phase value, R2* value, and T2* value. Conclusions The phase value, R2* value and T2* value can distinguish PCa and normal PZ, PCa and BPH, so they are valuable for the diagnosis and differential diagnosis of PCa, moreover, the diagnostic efficiency of R2* value is better than other indices.