Advanced zoomed diffusion-weighted imaging vs. full-field-of-view diffusion-weighted imaging in prostate cancer detection: a radiomic features study.

Objectives: We aimed to compare the efficiency of prostate cancer (PCa) detection using a radiomics signature based on advanced zoomed diffusion-weighted imaging and conventional full-field-of-view DWI.

Methods: A total of 136 patients, including 73 patients with PCa and 63 without PCa, underwent multi-parametric magnetic resonance imaging (mp-MRI). Radiomic features were extracted from prostate lesion areas segmented on full-field-of-view DWI with b-value = 1500 s/mm (f-DWI), advanced zoomed DWI images with b-value = 1500 s/mm (z-DWI), calculated zoomed DWI with b-value = 2000 s/mm (z-calDWI), and apparent diffusion coefficient (ADC) maps derived from both sequences (f-ADC and z-ADC). Single-imaging modality radiomics signature, mp-MRI radiomics signature, and a mixed model based on mp-MRI and clinically independent risk factors were built to predict PCa probability. The diagnostic efficacy and the potential net benefits of each model were evaluated.

Results: Both z-DWI and z-calDWI had significantly better predictive performance than f-DWIb1500 (z-DWIb1500 vs. f-DWIb1500: p = 0.048; z-calDWIb2000 vs. f-DWIb1500: p = 0.014). z-ADC had a slightly higher area under the curve (AUC) value compared with f-ADC value but was not significantly different (p = 0.127). For predicting the presence of PCa, the AUCs of clinical independent risk factors model, mp-MRI model, and mixed model were 0.81, 0.93, and 0.94 in training sets, and 0.74, 0.92, and 0.93 in validation sets, respectively.

Conclusion: Radiomics signatures based on the z-DWI technology had better diagnostic accuracy for PCa than that based on the f-DWI technology. The mixed model was better at diagnosing PCa and guiding clinical interventions for patients with suspected PCa compared with mp-MRI signatures and clinically independent risk factors.

Key Points: • Advanced zoomed DWI technology can improve the diagnostic accuracy of radiomics signatures for PCa. • Radiomics signatures based on z-calDWI have the best diagnostic performance among individual imaging modalities. • Compared with the independent clinical risk factors and the mp-MRI model, the mixed model has the best diagnostic efficiency.