The utility of apparent diffusion coefficient values in the risk stratification of prostate cancer using a 1.5T magnetic resonance imaging without endorectal coil
To evaluate the relationship between mean apparent diffusion coefficient (ADC) and post-surgical Gleason scores. To determine the diagnostic accuracy of multiparametric magnetic resonance imaging (mp-MRI) on a 1.5T magnet in distinguishing low, intermediate and high-grade prostate tumors.
Material and methods
This is a retrospective institutional-review-board-approved, single-center study including 30 patients (median age, 60 years) who underwent mp-MRI before prostatectomy for prostate cancer. Using histological reports for guidance, the tumors were localized in ADC maps, and mean ADCs were measured and examined for correlation with Gleason scores. 2 patients had 2 measurable foci, so a total of 32 tumors were studied. The diagnostic accuracy of the mean ADC was assessed by using the area under the receiver operating characteristic curve (ROC).
In the differentiation of tumors with a Gleason score of 6 from those with a Gleason score of at least 7, mean ADC yielded an AUC of 0.76 (95% confidence interval: 0.59, 0.93). In the differentiation of tumors with Gleason scores of 6 or 7 from those with a Gleason score of at least 8, mean ADC yielded an AUC of 0.94 (95% confidence interval: 0.86, 1.00).
Mean ADC values may allow a correct assessment of the patient risk using a 1.5T magnet without ERC.
2 B. Turkbey,P.S. Albert,K. Kurdziel,P.L. Choyke Imaging localized prostate cancer: current approaches and new developments Am J Roentgenol, 192 (2009), pp. 1471-1480
3 J.O. Barentsz,J. Richenberg,R. Clements,P. Choyke,S. Verma,G. Villeirs ESUR prostate MR guidelines 2012
Eur Radiol, 22 (2012), pp. 746-757 http://dx.doi.org/10.1007/s00330-011-2377-y
4 B. Turkbey,H. Mani,O. Aras,J. Ho,A. Hoang,A.R. Rastinehad Prostate cancer: can multiparametric MR imaging help identify patients who are candidates for active surveillance? Radiology, 268 (2013), pp. 144-152 http://dx.doi.org/10.1148/radiol.13121325
5 H.A. Vargas,O. Akin,T. Franiel,Y. Mazaheri,J. Zheng,C. Moskowitz Diffusion-weighted endorectal MR imaging at 3T for prostate cancer: tumor detection and assessment of aggressiveness Radiology, 259 (2011), pp. 775-784 http://dx.doi.org/10.1148/radiol.11102066
6 L.K. Bittencourt,J.O. Barentsz,L.C.D. de Miranda,E.L. Gasparetto Prostate MRI: diffusion-weighted imaging at 1.5T correlates better with prostatectomy Gleason Grades than TRUS-guided biopsies in peripheral zone tumours
Eur Radiol, 22 (2012), pp. 468-475 http://dx.doi.org/10.1007/s00330-011-2269-1
7 M. Chen,H.D. Dang,J.Y. Wang,C. Zhou,S.Y. Li,W.C. Wang Prostate cancer detection: comparison of T2-weighted imaging, diffusion-weighted imaging, proton magnetic resonance spectroscopic imaging, and the three techniques combined Acta Radiol, 49 (2008), pp. 602-610 http://dx.doi.org/10.1080/02841850802004983
8 A. Qayyum Diffusion-weighted imaging in the abdomen and pelvis: concepts and applications Radiographics, 29 (2009), pp. 1797-1810 http://dx.doi.org/10.1148/rg.296095521
9 R. Shimofusa,H. Fujimoto,H. Akamata,K. Motoori,S. Yamamoto,T. Ueda Diffusion-weighted imaging of prostate cancer J Comput Assist Tomogr, 29 (2005), pp. 149-153
10 B. Turkbey,V.P. Shah,Y. Pang,M. Bernardo,S. Xu,J. Kruecker Is apparent diffusion coefficient associated with clinical risk scores for prostate cancers that are visible on 3-T MR images? Radiology, 258 (2010), pp. 488-495 http://dx.doi.org/10.1148/radiol.10100667
11 K. Kitajima,S. Takahashi,Y. Ueno,H. Miyake,M. Fujisawa,F. Kawakami Do apparent diffusion coefficient (ADC) values obtained using high b-values with a 3-T MRI correlate better than a transrectal ultrasound (TRUS)-guided biopsy with true Gleason scores obtained from radical prostatectomy specimens for patients with prostat
Eur J Radiol, 82 (2013), pp. 1219-1226 http://dx.doi.org/10.1016/j.ejrad.2013.02.021
12 S. Verma,A. Rajesh,H. Morales,L. Lemen,G. Bills,M. Delworth Assessment of aggressiveness of prostate cancer: correlation of apparent diffusion coefficient with histologic grade after radical prostatectomy Am J Roentgenol, 196 (2011), pp. 374-381
13 D. Koh,A. Sohaib Diffusion-weighted imaging of the male pelvis Radiol Clin N Am, 50 (2012), pp. 1127-1144 http://dx.doi.org/10.1016/j.rcl.2012.08.008
14 G. Giannarini,G. Petralia,H.C. Thoeny Potential and limitations of diffusion-weighted magnetic resonance imaging in kidney, prostate, and bladder cancer including pelvic lymph node staging: a critical analysis of the literature Eur Urol, 61 (2012), pp. 326-340 http://dx.doi.org/10.1016/j.eururo.2011.09.019
15 M. Sadinski,M. Medved,I. Karademir,S. Wang,Y. Peng,Y. Jiang Short-term reproducibility of apparent diffusion coefficient estimated from diffusion-weighted MRI of the prostate Abdom Imaging, 40 (2015), pp. 2523-2528 http://dx.doi.org/10.1007/s00261-015-0396-x
16 N. Lawrentschuk,L. Klotz Active surveillance for low-risk prostate cancer: an update Nat Rev Urol, 8 (2011), pp. 312-320 http://dx.doi.org/10.1038/nrurol.2011.50
17 M. Large,S. Eggener Active surveillance for low-risk localized prostate cancer Oncol Willist Park, 23 (2009), pp. 974-979
18 G. Ravizzini,B. Turkbey,K. Kurdziel,P.L. Choyke New horizons in prostate cancer imaging Eur J Radiol, 70 (2009), pp. 212-226 http://dx.doi.org/10.1016/j.ejrad.2008.09.019
19 H. Hricak,P. Choyke,S.C. Eberhardt,S.A. Leibel,P.T. Scardino Imaging prostate cancer: a multidisciplinary perspective Radiology, 243 (2007), pp. 28-53 http://dx.doi.org/10.1148/radiol.2431030580
20 C.A. Ben,N. Girouin,M. Colombel,J.M. Maréchal,A. Gelet,A. Bissery Evaluation of T2-weighted and dynamic contrast-enhanced MRI in localizing prostate cancer before repeat biopsy Eur Radiol, 19 (2009), pp. 770-778 http://dx.doi.org/10.1007/s00330-008-1190-8
21 S. Heijmink,J.J. Fütterer,T. Hambrock,S. Takahashi,T.W. Scheenen,H.J. Huisman Prostate cancer: body-array versus endorectal coil MR imaging at 3T – comparison of image quality, localization, and staging performance
Radiology, 244 (2007), pp. 184-195 http://dx.doi.org/10.1148/radiol.2441060425