Objective:

To explore the application value of apparent diffusion coefficient (ADC) and exponential ADC (eADC) in bi-parametric magnetic resonance imaging (bpMRI) in detecting clinical significant prostate cancer.

Methods:

The clinical

imaging and pathological data of 101 patients with clinically suspected prostate cancer who were treated in Medical University Electric Power Teaching Hospital from January 2014 to December 2021 were retrospectively analyzed. According to the pathological results

the patients were divided into group 1 (clinical significant prostate cancer group) and group 2 (non-clinical significant prostate cancer + non-prostate cancer). Two radiographers used Prostate Imaging Reporting and Data System (PI-RADS) to scored the prostate MRI images of all patients according to the two schemes of mpMRI and bpMRI

and measured the ADC value and eADC value of the lesions. Logistic regression model was constructed by combining bpMRI score or mpMRI score with ADC value or eADC value respectively

and receiver operating characteristic (ROC) curve was drawn to evaluate the diagnostic efficacy of the ADC value

eADC value

bpMRI scheme

mpMRI scheme and the logistic regression model of bpMRI scheme or mpMRI scheme combined with ADC value or eADC value. The area under curve (AUC) of each scheme was compared by Z test.

Results:

Among 109 suspected lesions

50 lesions were divided into group 1 and 59 were divided into group 2. ADC values

eADC values

BpMRI score and mpMRI score were effective indicators in diagnosis of clinical significant prostate cancer (

P

＜0.001). The AUC values of ADC value and eADC value were 0.888 and 0.931 respectively

but there was no statistically significant difference between ADC value and eADC value (

Z

=1.512

P

=0.130 6). The AUC values of bpMRI score combined with ADC value or eADC value were 0.973 and 0.978 respectively

were higher than the AUC value of bpMRI score (AUC=0.954)

and the difference was statistically significant (

Z

=2.391

P

=0.016 8;

Z

=2.125

P

=0.033 6). The AUC values of mpMRI score combined with ADC value or eADC value were 0.985 and 0.985 respectively

were higher than the AUC value of mpMRI score (AUC=0.974)

But the difference was no statistically significant (

Z

=1.295

P

=0.195 3;

Z

=1.354

P

=0.175 7).

Conclusion:

Both ADC value and eADC value are valuable quantitative MRI indicators in diagnosis of clinical significant prostate cancer

and combing the two values with bpMRI score can effectively improve the diagnostic efficiency and clinical application value of bpMRI schemes.