Amide Proton Transfer and Intravoxel Incoherent Motion Imaging for Risk stratification of PI-RADS 3 Lesions in the Prostate Transitional Zone

Motivation: The positive rate of PI-RADS 3 biopsy was low,Moreover, many Gleason 3+3 lesions, due to repeated biopsies, ultimately opt for more aggressive treatment in a short time. Goal(s): To evaluate the ability of Prostate-Specific Antigen Density (PSAD) , Amide Proton Transfer (APT) and Intravoxel Incoherent Motion (IVIM) in risk stratification of PI-RADS 3 lesions . Approach: PSAD (PSA/prostate volume) was calculated with prostate volume. Conventional MRI sequences and APT, IVIM imaging were acquired in 3T MR. Results: PSAD, APT, and IVIM can further effectively stratify the risk of PI-RADS 3 lesions , potentially reducing unnecessary biopsies . Among these, APT exhibited the highest Area Under the Curve. Impact: PSAD, APT, and IVIM can distinguish clinically significant prostate cancer from non-clinically significant prostate cancer and benign prostatic hyperplasia in PI-RADS 3 lesions of the transitional zone, thereby reducing unnecessary biopsies.