Sung Yoon Park1, Young Taik Oh1, Dae Chul Jung1, Nam Hoon Cho2, Young Deuk Choi3, Koon Ho Rha3, Sung Joon Hong3. 1. Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea. 2. Department of Pathology, Yonsei University College of Medicine, Seoul, Korea. 3. Department of Urology, Yonsei University College of Medicine, Seoul, Korea.
Abstract
OBJECTIVE: To analyse whether diffusion-weighted imaging (DWI) predicts Gleason score (GS) upgrading in biopsy-proven low grade prostate cancer (PCa). PATIENTS AND METHODS: A total of 132 patients who had biopsy-proven low grade (GS < 7) PCa, 3T DWI results, and surgical confirmation were retrospectively included in the study. Clinical variables (prostate-specific antigen, greatest percentage of cancer in a biopsy core and percentage of positive cores) and DWI variables (minimum apparent diffusion coefficient [ADCmin ] and mean ADC [ADCmean ]) were evaluated. ADCmin was measured, by two independent, blinded readers, using a region of interest (ROI) of 5-10 mm2 at the area of lowest ADC value within a cancer, while ADCmean was measured using an ROI covering more than half of a cancer. Logistic regression and receiver-operating characteristic curve analyses were performed. RESULTS: 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 variables were not (P > 0.05). In both readers' results, the area under the curve (AUC) of ADCmin was significantly greater than that of ADCmean (reader 1: AUC 0.760 vs 0.711; P < 0.001; reader 2: AUC 0.752 vs 0.714; P = 0.003). CONCLUSION: Our results showed that DWI may predict GS upgrading of biopsy-proven low grade PCa. The variable ADCmin in PCa may perform better than ADCmean .
OBJECTIVE: To analyse whether diffusion-weighted imaging (DWI) predicts Gleason score (GS) upgrading in biopsy-proven low grade prostate cancer (PCa). PATIENTS AND METHODS: A total of 132 patients who had biopsy-proven low grade (GS < 7) PCa, 3T DWI results, and surgical confirmation were retrospectively included in the study. Clinical variables (prostate-specific antigen, greatest percentage of cancer in a biopsy core and percentage of positive cores) and DWI variables (minimum apparent diffusion coefficient [ADCmin ] and mean ADC [ADCmean ]) were evaluated. ADCmin was measured, by two independent, blinded readers, using a region of interest (ROI) of 5-10 mm2 at the area of lowest ADC value within a cancer, while ADCmean was measured using an ROI covering more than half of a cancer. Logistic regression and receiver-operating characteristic curve analyses were performed. RESULTS: 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 variables were not (P > 0.05). In both readers' results, the area under the curve (AUC) of ADCmin was significantly greater than that of ADCmean (reader 1: AUC 0.760 vs 0.711; P < 0.001; reader 2: AUC 0.752 vs 0.714; P = 0.003). CONCLUSION: Our results showed that DWI may predict GS upgrading of biopsy-proven low grade PCa. The variable ADCmin in PCa may perform better than ADCmean .
Authors: Jorge Abreu-Gomez; Daniel Walker; Tareq Alotaibi; Matthew D F McInnes; Trevor A Flood; Nicola Schieda Journal: Eur Radiol Date: 2020-03-24 Impact factor: 5.315
Authors: Piotr Zapała; Bartosz Dybowski; Ewa Bres-Niewada; Tomasz Lorenc; Agnieszka Powała; Zbigniew Lewandowski; Marek Gołębiowski; Piotr Radziszewski Journal: Int Urol Nephrol Date: 2019-06-10 Impact factor: 2.370