Quantitative Histogram Analysis of 5.0T Multiparametric MRI for Discrimination Between Prostate Cancer and Benign Hyperplasia
Abstract
Introduction Accurate differentiation between prostate cancer (PCa) and benign prostatic hyperplasia (BPH) remains a critical diagnostic challenge with direct implications for clinical management, in part due to the inherent subjectivity of the clinical reference standard Prostate Imaging Reporting and Data System version 2.1 (PI-RADS v2.1). This study aimed to validate the diagnostic efficacy of ultra-high-field 5.0T multiparametric magnetic resonance imaging (mpMRI) histogram analysis for PCa and BPH differentiation. Methods This retrospective consecutive cohort study enrolled 85 patients (41 with pathologically confirmed PCa and 44 with BPH). Fourteen standardized histogram features were extracted from apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM) parameters (D, D*, and f), and T2 mapping sequences. A multiparametric diagnostic model was constructed and validated via 5-fold stratified cross-validation. Results Multiple histogram parameters showed statistically significant between-group differences after Holm-Bonferroni correction for multiple comparisons (all P < 0.001), with the minimum ADC value demonstrating strong negative correlations with serum prostate-specific antigen (PSA) level (r = –0.578, P < 0.001) and Gleason score (r = –0.767, P < 0.001); the cross-validated multiparametric model yielded a mean area under the curve (AUC) of 0.9667 (95% CI: 0.924–1.000), which achieved superior diagnostic accuracy compared with the…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 85 participants or records.
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