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Investigation Reseach
Intravoxel incoherent motion diffusion-weighted imaging for assessment of the differential diagnosis and Gleason grade in prostate cancer: a Meta-analysis
GUO Dingbo  ZENG Guofei  YANG Hua  LI Xuejiao  OU Fangyuan 

Cite this article as: Guo DB, Zeng GF, Yang H, et al. Intravoxel incoherent motion diffusion-weighted imaging for assessment of the differential diagnosis and Gleason grade in prostate cancer: a Meta-analysis[J]. Chin J Magn Reson Imaging, 2022, 13(2): 69-74. DOI:10.12015/issn.1674-8034.2022.02.014.

[Abstract] Objective To explore the value of parameters of intravoxel incoherent motion (IVIM) diffusion-weighted imaging (DWI), including apparent diffusion coefficient (ADC), true diffusion coefficient (D), pseudo-diffusion coefficient (D*) and perfusion fraction (f) in the differential diagnosis and Gleason grade of prostate cancer (PCa).Materials and Methods A literature search on Embase, Medline, PubMed and Cochrane Library was performed to identify all the relevant studies characterizing differential diagnosis and Gleason grade of PCa by IVIM DWI published until August 2021. Stata 15.0 software was used for statistics analysis, for continuous variables, weighted mean difference (WMD) with corresponding 95% confidence interval (95% CI) was used as the statistical effect size, and forest maps were drawn. In addition, subgroup analysis was conducted to assess for heterogeneity, and risk of bias was assessed by Begg's test.Results A total of 13 articles were included, involving 504 patients and 821 ROIs. The pooled results of IVIM parameters for differentiating between PCa and healthy peripheral zone (PZ) showed that ADC, D and f values were significantly lower in regions of PCa compared to those of regions of PZ {WMD=-0.82 [95% CI (-1.01--0.64)], Z=8.69, P<0.0001; WMD=-0.54 [95% CI (-0.78--0.29)], Z=4.34, P<0.0001; WMD=-6.91 [95% CI (-12.12--1.70)], Z=2.60, P<0.0001}. In addition, D was significantly lower than ADC in the regions of PCa {WMD=-0.20 [95% CI (-0.38--0.03)], Z=2.26, P=0.02}. Compared with the low-grade (LG) PCa group, the pooled results showed that ADC value and D value in intermediate/high-grade (HG) PCa were significantly decreased {WMD=-0.24 [95% CI (-0.30--0.19)], Z=8.06, P<0.001; WMD=-0.25 [95% CI (-0.33--0.17)], Z=5.99, P<0.001}.Conclusions IVIM parameters are suitable for the differential diagnosis of PCa, and the D value may be more valuable than the ADC value in the characterization of PCa lesions. In addition, ADC value and D value can further distinguish LG and HG prostate cancer.
[Keywords] prostate cancer;intravoxel incoherent motion;diffusion-weighted imaging;Gleason grade;differential diagnosis

GUO Dingbo   ZENG Guofei   YANG Hua   LI Xuejiao   OU Fangyuan*  

Department of Radiology, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400021, China

OU FY, E-mail:

Conflicts of interest   None.

ACKNOWLEDGMENTS Chongqing Natural Science Foundation of China (No. cstc2020jcyj-msxmX0751); Joint Medical Research Project of Chongqing Science and Technology Commission and Chongqing Health Commission (No. 2019QNXM010).
Received  2021-10-09
Accepted  2021-12-31
DOI: 10.12015/issn.1674-8034.2022.02.014
Cite this article as: Guo DB, Zeng GF, Yang H, et al. Intravoxel incoherent motion diffusion-weighted imaging for assessment of the differential diagnosis and Gleason grade in prostate cancer: a Meta-analysis[J]. Chin J Magn Reson Imaging, 2022, 13(2): 69-74. DOI:10.12015/issn.1674-8034.2022.02.014.

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