Differentiation of prostate cancer lesions with high and with low Gleason score by diffusion-weighted MRI.

To differentiate prostate cancer lesions with high and with low Gleason score by diffusion-weighted-MRI (DW-MRI).

This prospective study was approved by the responsible ethics committee. DW-MRI of 84 consenting prostate and/or bladder cancer patients scheduled for radical prostatectomy were acquired and used to compute apparent diffusion coefficient (ADC), intravoxel incoherent motion (IVIM: the pure diffusion coefficient D t, the pseudo-diffusion fraction F p and the pseudo-diffusion coefficient D p), and high b value (as acquired and Hessian filtered) parameters within the index lesion. These parameters (separately and combined in a logistic regression model) were used to differentiate lesions depending on whether whole-prostate histopathological analysis after prostatectomy determined a high (≥7) or low (6) Gleason score.

Mean ADC and D t differed significantly (p of independent two-sample t test < 0.01) between high- and low-grade lesions. The highest classification accuracy was achieved by the mean ADC (AUC 0.74) and D t (AUC 0.70). A logistic regression model based on mean ADC, mean F p and mean high b value image led to an AUC of 0.74 following leave-one-out cross-validation.

Classification by IVIM parameters was not superior to classification by ADC. DW-MRI parameters correlated with Gleason score but did not provide sufficient information to classify individual patients.

• Mean ADC and diffusion coefficient differ between high- and low-grade prostatic lesions. • Accuracy of trivariate logistic regression is not superior to using ADC alone. • DW-MRI is not a valid substitute for biopsies in clinical routine yet.

European radiology. 2016 Jun 14 [Epub ahead of print]

Sebastiano Barbieri, Michael Brönnimann, Silvan Boxler, Peter Vermathen, Harriet C Thoeny

Institute of Diagnostic, Pediatric, and Interventional Radiology, Inselspital University Hospital, Inselspital, Freiburgstrasse 10, CH-3010, Bern, Switzerland., Institute of Diagnostic, Pediatric, and Interventional Radiology, Inselspital University Hospital, Inselspital, Freiburgstrasse 10, CH-3010, Bern, Switzerland., Department of Urology, Inselspital, Inselspital University Hospital, Bern, Switzerland., Institute of Diagnostic, Pediatric, and Interventional Radiology, Inselspital University Hospital, Inselspital, Freiburgstrasse 10, CH-3010, Bern, Switzerland., Institute of Diagnostic, Pediatric, and Interventional Radiology, Inselspital University Hospital, Inselspital, Freiburgstrasse 10, CH-3010, Bern, Switzerland. .

E-Newsletters

Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.

Subscribe