Assessment of Aggressiveness of Prostate Cancer: Correlation of Apparent Diffusion Coefficient With Histologic Grade After Radical Prostatectomy

Verma, Sadhna; Arora, Rajesh; Morales, Humberto; Lemen, Lisa; Bills, Gordon; Delworth, Mark G.; Gaitonde, Krish; Ying, Jun; Samartunga, Ranasinghe; Lamba, Michael

doi:10.2214/ajr.10.4441

Cited by 192 publications

(121 citation statements)

References 33 publications

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“…It has been shown that ADC values were negatively correlated with the postsurgical GS in PCA patients. The ADC was furthermore sufficient to predict the presence of low-grade and high-grade PCA in the peripheral zone (PZ) (14)(15)(16). Regarding T2-weighted (T2W) images, it has been demonstrated that PCA have lower T2 signal intensity (SI) than non-neoplastic tissue (11).…”

Section: Introductionmentioning

confidence: 99%

The value of ADC, T2 signal intensity, and a combination of both parameters to assess Gleason score and primary Gleason grades in patients with known prostate cancer

et al. 2014

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Background: The ability to non-invasively analyze tumor aggressiveness is an important predictor for individual treatment stratification and patient outcome in prostate cancer (PCA). Purpose: To evaluate: (i) whether apparent diffusion coefficient (ADC), the T2 signal intensity (SI), and a combination of both parameters allow for an improved discrimination of Gleason Score (GS) !7 (intermediate and high risk) and GS <7 (low risk) in PCA; and (ii) whether ADC may distinguish between 3 þ 4 and 4 þ 3 PCA (primary Gleason grades [pGG]). Material and Methods: Prostatectomy specimens of 66 patients (mean age, 63 AE 5.6 years; 104 PCA foci) with a preceding multiparametric 1.5 T endorectal coil magnetic resonance imaging (MRI) were included. ADC (b values ¼ 0, 100, 400, 800 s/mm 2 ), standardized T2 (T2s), and the ADC/T2s ratio were tested for correlation with GS applying multivariate analysis. ADC cutoff values were calculated for prediction of GS and pGG, and logarithm of the odds (LOGIT) was used to express the probability for GS and pGG. Diagnostic accuracy was assessed by ROC analysis. Results: We found an almost linear negative relationship of ADC for GS !7 (P ¼ 0.002). The effect of ADC for GS !7 (adjusted odds ratio ¼ 0.995) was almost identical for peripheral and transition zone PCA (P ¼ 0.013 and P < 0.001, respectively). ADC showed an AUC of 78.9% for discrimination between GS <7 and GS !7. An ADC cutoff of <1.005 Â 10 À3 mm 2 /s indicated a GS !7 (90.5% sensitivity, 62.5% specificity). Within the group of GS ¼ 7 PCA, an ADC > 0.762 Â 10 À3 mm 2 /s indicated a pGG of 3 (AUC ¼ 69.6%). Conclusion: T2s and the ADC/T2s ratio do not provide additional information regarding prediction of GS. ADC values have a good discriminatory power to distinguish tumors with GS !7 from GS <7 and to predict pGG in GS ¼ 7 PCA.

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Section: Introductionmentioning

confidence: 99%

The value of ADC, T2 signal intensity, and a combination of both parameters to assess Gleason score and primary Gleason grades in patients with known prostate cancer

et al. 2014

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“…On the other hand, ADC values generated from multiple b-values give an objective measurement of tissue diffusion and are a surrogate for tumor aggressiveness [5,25] . The values broadly change inversely with Gleason score and the trend is lower in higher stage of disease, although there are some overlaps between benign and malignant tissue [5,25,26] . Gains in sensitivity with higher tADC values would be expected to be offset by lower specificity and a balance between these outcome parameters is required.…”

Section: Discussionmentioning

confidence: 99%

Threshold-based parametric analysis of diffusion-weighted magnetic resonance imaging at 3.0 Tesla to identify men with prostate cancer

et al. 2015

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Abstract:The aim of this study is to determine the accuracy of three apparent diffusion coefficient (ADC) threshold values in detecting prostate cancer (PCa) prior to prostate biopsy. Sixty men with clinical suspicion of PCa underwent endorectal diffusion-weighted magnetic resonance imaging (DW-MRI) at 3.0 Tesla (T). Three ADC threshold values (tADC: 1.0, 1.2 and 1.4 × 10 −3 mm 2 /s) were sequentially applied to ADC maps for the detection of malignant lesions in the prostatic peripheral zone (PZ). Segment-based and patient-specific PCa detection performance of these tADC values was correlated with the histopathological results from the subsequent 12-core transrectal ultrasound (TRUS)-guided biopsy. Mean of ADC and area size of the identified malignant region of interests (ROIs) were recorded. Accuracy for PCa detection was assessed by receiver operating characteristic curves. 1.0 × 10 −3 mm 2 /s of tADC provided 79% sensitivity, 97% specificity and 93% positive predictive value for PCa. Area size of the malignant ROI was a good independent factor for PCa detection (Area under curve, AUC = 0.85). ROI area size 0.2 cm 2 was identified as the best

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“…Increasing PSA levels with subtle changes in ADC raise suspicious of tumor recurrence. ADC values are found to be negatively correlated with the post-surgical Gleason grade in patients with prostate cancer 12 . Our results show that ADC values might help to predict PC, especially for tumors in the peripheral zone.…”

Section: Tumor Localisationmentioning

confidence: 93%

“…Our results show that ADC values might help to predict PC, especially for tumors in the peripheral zone. Given the substantial overlap in the ADC values, the addition of the other MR parameters, such as volumetry and technical improvements in DWI might improve accuracy in the stratification of patient 12 . On DCE-MRI, PC shows early nodular enhancement before the rest of the parenchyma and early washout of contrast medium based on the pathologic microvasculature in the tumor (Fig.…”

Section: Tumor Localisationmentioning

confidence: 99%

Prostate cancer - the role of magnetic resonance imaging

Mocikova

Babela²,

Balaz³

2012

BIOMED PAP

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Background. This article reviews the potential of magnetic resonance imaging (MRI) in prostate cancer diagnosis. Methods. Systematic scan of Pubmed, Ovid, Medline, Elsevier search engines was used, additional information was found through bibliographic review of relevant articles. Results. Substantial progress has been made in the imaging of prostate cancer in MR imaging, as well as in advanced MR spectroscopy. Conclusions. MRI is a non-invasive and direct imaging modality useful for cancer staging, therapy response, detection of recurrence and guided biopsy in previous negative biopsies. MRI with 3.0 T system, whole-body MRI, dynamic contrast enhanced MRI, diffusion-weighted imaging (DWI) and MR spectroscopy (MRS) have improved tumor staging, assessment of tumor volume, aggressiveness or recurrence. Implementation of endorectal/phased array superficial MRI findings on 1.5 or 3.0 T systems into nomograms for prostate pretreatment prediction is warranted. Surface phasedarray coil MRI accurately defines prostate cancer with elevated risk of extraprostatic disease.

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Assessment of Aggressiveness of Prostate Cancer: Correlation of Apparent Diffusion Coefficient With Histologic Grade After Radical Prostatectomy

Cited by 192 publications

References 33 publications

The value of ADC, T2 signal intensity, and a combination of both parameters to assess Gleason score and primary Gleason grades in patients with known prostate cancer

The value of ADC, T2 signal intensity, and a combination of both parameters to assess Gleason score and primary Gleason grades in patients with known prostate cancer

Threshold-based parametric analysis of diffusion-weighted magnetic resonance imaging at 3.0 Tesla to identify men with prostate cancer

Prostate cancer - the role of magnetic resonance imaging

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