Diffusion kurtosis imaging study of prostate cancer: Preliminary findings

Purpose To evaluate the differences in parameters of diffusion kurtosis imaging (DKI) between prostate cancer, benign prostatic hyperplasia (BPH), and benign peripheral zone (PZ). Materials and Methods Twenty-four foci of prostate cancer, 41 BPH nodules (14 stromal and 27 nonstromal hyperplasia), and 20 benign PZ from 20 patients who underwent radical prostatectomy were investigated. Diffusion-weighted imaging (DWI) was performed using 11 b-values (0-1500 s/mm²). DKI model relates DWI signal decay to parameters that reflect non-Gaussian diffusion coefficient (D) and deviations from normal distribution (K). A mixed model analysis of variance and receiver operating characteristic (ROC) analyses were performed to assess the statistical significance of the metrics of DKI and apparent diffusion coefficient (ADC). Results K was significantly higher in prostate cancer and stromal BPH than in benign PZ (1.19 ± 0.24 and 0.99 ± 0.28 versus 0.63 ± 0.23, P < 0.001 and P < 0.001, respectively). K showed a trend toward higher levels in prostate cancer than in stromal BPH (1.19 ± 0.24 versus 0.99 ± 0.28, P = 0.051). On the ROC analyses, a significant difference in area under the curve was not observed between K and ADC, however, K showed the highest sensitivity among three parameters. Conclusion DKI may contribute to the imaging diagnosis of prostate cancer, especially in the differential diagnosis of prostate cancer and BPH.