Background: To explore the usefulness of analyzing histograms and textures of apparent diffusion coefficient (ADC) maps and T2-weighted (T2W) images to differentiate prostatic cancer (PCa) from benign prostatic hyperplasia (BPH) using histopathology as the reference.Methods: Ninety patients with PCa and 112 patients with BPH were included in this retrospective study. Differences in whole-lesion histograms and texture parameters of ADC maps and T2W images between PCa and BPH patients were evaluated using the independent samples t-test. The diagnostic performance of ADC maps and T2W images in being able to differentiate PCa from BPH was assessed using receiver operating characteristic (ROC) curves.Results : The mean, median, 5th, and 95thpercentiles of ADC values in images from PCa patients were significantly lower than those from BPH patients (p < 0.05). Significant differences were observed in the means, standard deviations, medians, kurtosis, skewness, and 5thpercentile values of T2W image between PCa and BPH patients (p < 0.05). The ADC5thshowed the largest AUC (0.906) with a sensitivity of 83.3 % and specificity of 89.3 %. The diagnostic performance of the T2W image histogram and texture analysis was moderate and had the largest AUC of 0.634 for T2WKurtosiswith a sensitivity and specificity of 48.9% and 79.5 %, respectively. The diagnostic performance of the combined ADC5th& T2WKurtosisparameters was also similar to that of the ADC5th& ADCDiff−Variance.Conclusions: Histogram and texture parameters derived from the ADC maps and T2W images for entire prostatic lesions could be used as imaging biomarkers to differentiate PCa and BPH biologic characteristics, however, histogram parameters outperformed texture parameters in the diagnostic performance.
Background: Fractional flow reserve derived from computed tomography (FFRCT) has been demonstrated to improve identification of lesion-specific ischemia significantly compared with coronary computed tomography angiography (CCTA). It remains unclear whether the distribution of FFRCT values in obstructive stenosis between patients who received percutaneous coronary intervention (PCI) or not in routine clinical practice, as well as its association with clinical outcome. This study aims to reveal the distribution of FFRCT value in patients with single obstructive coronary artery stenosis and explored the independent factors for predicting major adverse cardiac events (MACE). Methods: This was a retrospective study of adults with non-ST-segment elevation acute coronary syndrome undergoing FFRCT assessment by using CCTA data from January 1, 2016 to December 31, 2020. Propensity score matching (PSM) method was used to account for patient selection bias. The risk factors for predicting MACE were evaluated by a Cox proportional hazards regression analysis. Results: Overall, 655 patients with single obstructive (≥ 50%) stenosis shown on CCTA were enrolled and divided into PCI group (279 cases) and conservative group (376 cases) according to treatment strategy. The PSM cohort analysis demonstrated that the difference in history of unstable angina, Canadian Cardiovascular Society Class (CCSC) and FFRCT between PCI group (188 cases) and conservative group (315 cases) was statistically significant, with all P values < 0.05, while the median follow-up time between them was not statistically significant (24 months vs. 22.5 months, P = 0.912). The incidence of MACE in PCI group and conservative group were 14.9% (28/188) and 23.5% (74/315) respectively, P = 0.020. Multivariate analysis of Cox proportional hazards regression revealed that history of unstable angina (adjusted odds ratio (adjOR), 3.165; 95% confidence interval (CI), 2.087–4.800; P < 0.001), FFRCT ≤ 0.8 (OR, 1.632;95% CI 1.095–2.431; P = 0.016), and PCI therapy (OR 0.481; 95% CI 0.305–0.758) were the independent factors for MACE. Conclusions: History of unstable angina and FFRCT value of ≤ 0.8 were the independent risk factors for MACE, while PCI therapy was the independent protective factor for MACE.