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Clinical Article
Feasibility study of three-dimensional amide proton transfer imaging in differentiating prostate cancer with and without bone metastasis
ZHANG Pengyun  TANG Yunxing  JIANG Haoyang  CHEN Lihua  ZHANG Qinhe  LIN Liangjie  LIU Ailian 

Cite this article as: Zhang PY, Tang YX, Jiang HY, et al. Feasibility study of three-dimensional amide proton transfer imaging in differentiating prostate cancer with and without bone metastasis[J]. Chin J Magn Reson Imaging, 2022, 13(12): 100-103, 110. DOI:10.12015/issn.1674-8034.2022.12.017.

[Abstract] Objective The study aims to explore the performance of 3D amide proton transfer (3D-APT) weighted imaging in differentiation of prostate cancer (PCa) with and without bone metastasis.Materials and Methods A total of 62 (from April 2019 to August 2022) pathology-proven PCa patient cases were included categorized into two groups: 21 PCas with bone metastasis, and 41 without bone metastasis. Bone metastasis was proved by emission computed tomography (ECT). MR scans were performed on a 3.0 T clinical scanner with the body coil to transmit RF pulse and a 16-channel abdominal coil to receive signals. MR sequences including 3D-APT, T2 weighted imaging (T2WI), and diffusion weighted imaging (DWI) were performed. All data were transferred to the IntelliSpace Portal workstation and processed independently by two observers using a double-blind method. According to T2WI and DWI images, the lesions were identified. On the 3D-APT and DWI fusion images, the circular region of interest (ROI) was manually delineated to measure the APT value. The mean APT values from the ROIs were used for statistical analysis by the SPSS 19.0 software (IBM). Measurement consistency of APT values between the two observers was tested using intra-class correlation coefficients (ICC). APT values were compared between twogroups using the t test. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic efficacy.Results Measurements by the two observers were in good agreement (ICC>0.75). APT values in group PCa with bone metastasis (2.76%±0.44%) were significantly higher than those in group PCa without bone metastasis (2.26%±0.64%) (P<0.05). The area under the ROC curves (AUC) of APT for distinguishing the lesions between two groups was 0.766. The diagnostic sensitivity and specificity were 71.43% and 70.73%, respectively, with the cut-off APT value of 2.50%.Conclusions In this study, 3D-APT imaging technology was used for the first time to distinguish PCa with and without bone metastasis, PCas with bone metastases were observed with significantly higher mean APT values than those without bone metastasis. The diagnostic sensitivity and specificity of APT imaging for differentiation of these two type PCas were good. Therefore, APT imaging may serve as a promising non-invasive method for clinical evaluation of the aggressiveness of PCa.
[Keywords] prostate cancer;bone metastasis;amide proton transfer weighted imaging;magnetic resonance imaging;emission computed tomography;diffusion weighted imaging

ZHANG Pengyun1   TANG Yunxing1   JIANG Haoyang1   CHEN Lihua1   ZHANG Qinhe1   LIN Liangjie2   LIU Ailian1*  

1 Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

2 Philips (China) Investment Co., LTD, Beijing Branch, Beijing 100016, China

Liu AL, E-mail:

Conflicts of interest   None.

Received  2022-02-24
Accepted  2022-11-29
DOI: 10.12015/issn.1674-8034.2022.12.017
Cite this article as: Zhang PY, Tang YX, Jiang HY, et al. Feasibility study of three-dimensional amide proton transfer imaging in differentiating prostate cancer with and without bone metastasis[J]. Chin J Magn Reson Imaging, 2022, 13(12): 100-103, 110. DOI:10.12015/issn.1674-8034.2022.12.017.

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