OBJECTIVES: To evaluate the incremental value of diffusion-weighted imaging (DWI) in combination with T2-weighted imaging to detect low (Gleason score, ≤ 6) and intermediate or high risk (Gleason score, ≥ 7) prostate cancer. METHODS: Fifty-one patients who underwent MRI before prostatectomy were evaluated. Two readers independently scored the probability of tumour in eight regions of prostate on T2-weighted images (T2WI) and T2WI combined with apparent diffusion coefficient (ADC) maps. Data were divided into two groups--low risk and intermediate or high risk prostate cancer--and correlated with histopathological results. Diagnostic performance parameters, areas under the receiver-operating characteristic curve (AUCs) and interreader agreement were calculated. RESULTS: For both readers, AUCs of combined T2WI and ADC maps were greater than those of T2WI in intermediate or high risk (reader 1, 0.887 vs. 0.859; reader 2, 0.732 vs 0.662, P < 0.05) prostate cancers, but not in low risk (reader 1, 0.719 vs 0.725; reader 2, 0.685 vs. 0.680, P > 0.05) prostate cancers. Weighted κ value of combined T2WI and ADC maps was 0.689. CONCLUSIONS: The addition of DWI to T2-weighted imaging improves the accuracy of detecting intermediate or high risk prostate cancers, but not for low risk prostate cancer detection. KEY POINTS: • Gleason scores influence diagnostic performance of MRI for prostate cancer detection. • Addition of DWI does not improve low risk prostate cancer detection. • Combined T2WI and DWI may help select intermediate or high risk patients.
OBJECTIVES: To evaluate the incremental value of diffusion-weighted imaging (DWI) in combination with T2-weighted imaging to detect low (Gleason score, ≤ 6) and intermediate or high risk (Gleason score, ≥ 7) prostate cancer. METHODS: Fifty-one patients who underwent MRI before prostatectomy were evaluated. Two readers independently scored the probability of tumour in eight regions of prostate on T2-weighted images (T2WI) and T2WI combined with apparent diffusion coefficient (ADC) maps. Data were divided into two groups--low risk and intermediate or high risk prostate cancer--and correlated with histopathological results. Diagnostic performance parameters, areas under the receiver-operating characteristic curve (AUCs) and interreader agreement were calculated. RESULTS: For both readers, AUCs of combined T2WI and ADC maps were greater than those of T2WI in intermediate or high risk (reader 1, 0.887 vs. 0.859; reader 2, 0.732 vs 0.662, P < 0.05) prostate cancers, but not in low risk (reader 1, 0.719 vs 0.725; reader 2, 0.685 vs. 0.680, P > 0.05) prostate cancers. Weighted κ value of combined T2WI and ADC maps was 0.689. CONCLUSIONS: The addition of DWI to T2-weighted imaging improves the accuracy of detecting intermediate or high risk prostate cancers, but not for low risk prostate cancer detection. KEY POINTS: • Gleason scores influence diagnostic performance of MRI for prostate cancer detection. • Addition of DWI does not improve low risk prostate cancer detection. • Combined T2WI and DWI may help select intermediate or high risk patients.
Authors: Niall M Corcoran; Matthew K H Hong; Rowan G Casey; Antonio Hurtado-Coll; Justin Peters; Laurence Harewood; S Larry Goldenberg; Chris M Hovens; Anthony J Costello; Martin E Gleave Journal: BJU Int Date: 2011-03-28 Impact factor: 5.588
Authors: Aytekin Oto; Cheng Yang; Arda Kayhan; Maria Tretiakova; Tatjana Antic; Christine Schmid-Tannwald; Scott Eggener; Gregory S Karczmar; Walter M Stadler Journal: AJR Am J Roentgenol Date: 2011-12 Impact factor: 3.959
Authors: Baris Turkbey; Vijay P Shah; Yuxi Pang; Marcelino Bernardo; Sheng Xu; Jochen Kruecker; Julia Locklin; Angelo A Baccala; Ardeshir R Rastinehad; Maria J Merino; Joanna H Shih; Bradford J Wood; Peter A Pinto; Peter L Choyke Journal: Radiology Date: 2010-12-21 Impact factor: 11.105
Authors: Courtney A Woodfield; Glenn A Tung; David J Grand; John A Pezzullo; Jason T Machan; Joseph F Renzulli Journal: AJR Am J Roentgenol Date: 2010-04 Impact factor: 3.959