OBJECTIVES: To investigate whether the apparent diffusion coefficient (ADC) from diffusion-weighted magnetic resonance imaging (DW-MRI) could help improve the prediction of insignificant prostate cancer in candidates for active surveillance (AS).
METHODS: Enrolled in this retrospective study were 287 AS candidates who underwent DW-MRI before radical prostatectomy. Patients were stratified into two groups; Group A consisted of patients with no visible tumour or a suspected tumour ADC value > 0.830 × 10-3 mm2/sec and Group B consisted of patients with a suspected tumour ADC value < 0.830 × 10-3 mm2/sec. We compared pathological outcomes in each group.
RESULTS: Group A had 243 (84.7 %) patients and Group B had 44 (15.3 %) patients. The proportion of organ-confined Gleason ≤ 6 disease and insignificant prostate cancer was significantly higher in Group A than Group B (61.3 % vs. 38.6 %, p = 0.005 and 47.7 % vs. 25.0 %, p = 0.005, respectively). On multivariate analysis, a high ADC value was the independent predictor of organ-confined Gleason ≤ 6 disease and insignificant prostate cancer (odds ratio = 2.43, p = 0.011 and odds ratio = 2.74, p = 0.009, respectively).
CONCLUSION: Tumour ADC values may be a useful marker for predicting insignificant prostate cancer in candidates for AS.
Kim TH, Jeong JY, Lee SW, Kim CK, Park BK, Sung HH, Jeon HG, Jeong BC, Seo SI, Lee HM, Choi HY, Jeon SS. Are you the author?
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, # 81 Irwon-Ro, Gangnam-gu, Seoul, 135-710, Republic of Korea.
Reference: Eur Radiol. 2015 Jan 31. Epub ahead of print.