Amide proton transfer imaging has added value for predicting extraprostatic extension in prostate cancer patients

Xiaoyan Qin; Jian Lv; Jianmei Zhang; Ronghua Mu; Wei Zheng; Fuzhen Liu; Bingqin Huang; Xin Li; Peng Yang; Kan Deng; Xiqi Zhu

doi:10.3389/fonc.2024.1327046

Amide proton transfer imaging has added value for predicting extraprostatic extension in prostate cancer patients

Front Oncol. 2024 Feb 29:14:1327046. doi: 10.3389/fonc.2024.1327046. eCollection 2024.

Authors

Xiaoyan Qin^#¹, Jian Lv^#¹, Jianmei Zhang^#¹, Ronghua Mu¹, Wei Zheng¹, Fuzhen Liu¹, Bingqin Huang^{1

2}, Xin Li¹, Peng Yang¹, Kan Deng³, Xiqi Zhu⁴

Affiliations

¹ Department of Radiology, Nanxishan Hospital of Guangxi Zhuang Autonomous Region, Guilin, China.
² Department of Radiology, Graduate School of Guilin Medical University, Guilin, China.
³ Philips (China) Investment Co., Ltd., Guangzhou Branch, Guangzhou, China.
⁴ Department of Radiology, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China.

^# Contributed equally.

Abstract

Background: Prostate cancer invades the capsule is a key factor in selecting appropriate treatment methods. Accurate preoperative prediction of extraprostatic extension (EPE) can help achieve precise selection of treatment plans.

Purpose: The aim of this study is to verify the diagnostic efficacy of tumor size, length of capsular contact (LCC), apparent diffusion coefficient (ADC), and Amide proton transfer (APT) value in predicting EPE. Additionally, the study aims to investigate the potential additional value of APT for predicting EPE.

Method: This study include 47 tumor organ confined patients (age, 64.16 ± 9.18) and 50 EPE patients (age, 61.51 ± 8.82). The difference of tumor size, LCC, ADC and APT value between groups were compared. Binary logistic regression was used to screen the EPE predictors. The receiver operator characteristic curve analysis was performed to assess the diagnostic performance of variables for predicting EPE. The diagnostic efficacy of combined models (model I: ADC+LCC+tumor size; model II: APT+LCC+tumor size; and model III: APT +ADC+LCC+tumor size) were also analyzed.

Results: APT, ADC, tumor size and the LCC were independent predictors of EPE. The area under the curve (AUC) of APT, ADC, tumor size and the LCC were 0.752, 0.665, 0.700 and 0.756, respectively. The AUC of model I, model II, and model III were 0.803, 0.845 and 0.869, respectively. The cutoff value of APT, ADC, tumor size and the LCC were 3.65%, 0.97×10-3mm2/s, 17.30mm and 10.78mm, respectively. The sensitivity/specificity of APT, ADC, tumor size and the LCC were 76%/89.4.0%, 80%/59.6%, 54%/78.9%, 72%/66%, respectively. The sensitivity/specificity of model I, Model II and Model III were 74%/72.3%, 82%/72.5% and 84%/80.9%, respectively.

Data conclusion: Amide proton transfer imaging has added value for predicting EPE. The combination model of APT balanced the sensitivity and specificity.

Keywords: amide proton transfer; diffusion weight imaging; extraprostatic extension; length of capsular contact; prostate cancer; tumor size.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. Social Development Program of Guilin (20210227-9-2). Development Plan project of Guangxi health bureau (Z20200603).