To analyze whether diffusion-weighted imaging (DWI) predicts Gleason score (GS) upgrading in biopsy-proven low-grade prostate cancers.
A total of 132 patients who have biopsy-proven low-grade (GS< 7) prostate cancers, 3T DWI, and surgical confirmation were retrospectively included.
Clinical [prostate-specific antigen, greatest percentage of biopsy core, and percentage of positive core number] and DWI parameters [minimum apparent diffusion coefficient (ADCmin ) and mean ADC (ADCmean )] were evaluated. ADCmin was measured using a region-of-interest of 5-10 mm(2) at the area of lowest ADC value within a cancer, while ADCmean was measured using a region-of-interest covering more than half of a cancer by two independent, blinded readers, respectively. Logistic regression and receiver operating-characteristic curve analyses were performed.
The rate of GS upgrading was 46. 1% (61/132). In both univariate and multivariate analyses, ADCmin and ADCmean were persistently significant for predicting GS upgrading (p< 0. 05), whereas clinical parameters were not (p> 0. 05). In both readers, the area of under curve (AUC) of ADCmin was significantly greater than that of ADCmean (AUCs of reader 1, 0. 760 versus 0. 711, p< 0. 001; AUCs of reader 2, 0. 752 versus 0. 714, p= 0. 003).
DWI may predict GS upgrading of biopsy-proven low-grade prostate cancers. The use of cancer ADCmin may allow better performance than ADCmean . This article is protected by copyright. All rights reserved.
BJU international. 2016 Jan 28 [Epub ahead of print]
Sung Yoon Park, Young Taik Oh, Dae Chul Jung, Nam Hoon Cho, Young Deuk Choi, Koon Ho Rha, Sung Joon Hong
Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine. , Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine. , Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine. , Department of Pathology, Yonsei University College of Medicine. , Department of Urology, Yonsei University College of Medicine. , Department of Urology, Yonsei University College of Medicine. , Department of Urology, Yonsei University College of Medicine.