OBJECTIVE: The purpose of our study was to identify low-risk prostate cancer on the basis of the D'Amico clinical risk score in patients with prostate-specific antigen (PSA) levels 10 ng/mL or less who had undergone radical prostatectomy by comparing apparent diffusion coefficient (ADC) with transrectal ultrasound (TRUS)-guided target biopsy.
MATERIALS AND METHODS: In the preliminary study, we used receiver operating characteristic (ROC) analysis and determined the cutoff ADC to identify prostate cancer with a Gleason score of 6 or less for 117 patients. In the primary study, we assessed the combination of routine MRI (T2-weighted and diffusion-weighted imaging) plus the cutoff ADC value ("method A") to identify low-risk prostate cancer for another 89 patients. Their diagnostic value was compared with that of routine MRI combined with the Gleason score obtained from TRUS-guided target biopsies ("method B").
RESULTS: The preliminary study showed that a mean ADC of 1.04 × 10-3 mm2/s was the best cutoff. In the primary study, accuracy was statistically higher with method A for each reader (p = 0.041).
CONCLUSION: In patients with PSA levels 10 ng/mL or less, the combination of MRI findings plus the cutoff ADC is significantly more accurate for the identification of low-risk prostate cancer than is the combination of MRI followed by TRUS-guided target biopsy.
Written by:
Itatani R, Namimoto T, Kajihara H, Katahira K, Kitani K, Hamada Y, Yamashita Y. Are you the author?
Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto, 860-8556, Japan.
Reference: AJR Am J Roentgenol. 2014 May;202(5):1051-7.
doi: 10.2214/AJR.13.11602
PubMed Abstract
PMID: 24758659
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