Raphaele Renard Penna1,2, Geraldine Cancel-Tassin3,4, Eva Comperat3,4,5, Pierre Mozer6, Priscilla Léon3,6, Justine Varinot3,5, Morgan Roupret3,4,6, Marc-Olivier Bitker3,6, Olivier Lucidarme7, Olivier Cussenot3,4,6,8. 1. Academic Department of Radiology, Pitie-Salpetriere Hospital, AP-HP, UPMC Univ Paris 06, 83 Boulevard de l'Hopital, 75013, Paris, France. raphaele.renardpenna@aphp.fr. 2. GRC n°5, ONCOTYPE-URO, Institut Universitaire de Cancerologie, UPMC Univ Paris 06, Paris, France. raphaele.renardpenna@aphp.fr. 3. GRC n°5, ONCOTYPE-URO, Institut Universitaire de Cancerologie, UPMC Univ Paris 06, Paris, France. 4. CeRePP, Paris, France. 5. Academic Department of Pathology, Pitie-Salpetriere Hospital, AP-HP, UPMC Univ Paris 06, Paris, France. 6. Academic Department of Urology, Pitie-Salpetriere Hospital, AP-HP, UPMC Univ Paris 06, Paris, France. 7. Academic Department of Radiology, Pitie-Salpetriere Hospital, AP-HP, UPMC Univ Paris 06, 83 Boulevard de l'Hopital, 75013, Paris, France. 8. Academic Department of Urology, Tenon Hospital, AP-HP, UPMC Univ Paris 06, Paris, France.
Abstract
PURPOSE: To evaluate the use of multiparametric MRI (mp MRI) parameters in order to predict prostate cancer aggressiveness as defined by pathological Gleason score or molecular markers in a cohort of patients defined with a Gleason score of 6 at biopsy. METHODS: Sixty-seven men treated by radical prostatectomy (RP) for a low grade (Gleason 6) on biopsy and mp MRI before biopsy were selected. The cycle cell proliferation (CCP) score assessed by the Prolaris test and Ki-67/PTEN expression assessed by immunohistochemistry were quantified on the RP specimens. RESULTS: 49.25 % of the cancers were undergraded on biopsy compared to the RP specimens. Apparent diffusion coefficient (ADC) < 0.80 × 10(-3) mm(2)/s (P value 0.003), Likert score >4 (P value 0.003) and PSA density >0.15 ng/ml/cc (P value 0.035) were significantly associated with a higher RP Gleason score. Regarding molecular markers of aggressiveness, ADC < 0.80 × 10(-3) mm(2)/s and Likert score >4 were also significantly associated with a positive staining for Ki-67 (P value 0.039 and 0.01, respectively). No association was found between any analyzed MRI or clinical parameter and the CCP score. CONCLUSION: Decreasing ADC value is a stronger indicator of aggressive prostate cancer as defined by molecular markers or postsurgical histology than biopsy characteristics.
PURPOSE: To evaluate the use of multiparametric MRI (mp MRI) parameters in order to predict prostate cancer aggressiveness as defined by pathological Gleason score or molecular markers in a cohort of patients defined with a Gleason score of 6 at biopsy. METHODS: Sixty-seven men treated by radical prostatectomy (RP) for a low grade (Gleason 6) on biopsy and mp MRI before biopsy were selected. The cycle cell proliferation (CCP) score assessed by the Prolaris test and Ki-67/PTEN expression assessed by immunohistochemistry were quantified on the RP specimens. RESULTS: 49.25 % of the cancers were undergraded on biopsy compared to the RP specimens. Apparent diffusion coefficient (ADC) < 0.80 × 10(-3) mm(2)/s (P value 0.003), Likert score >4 (P value 0.003) and PSA density >0.15 ng/ml/cc (P value 0.035) were significantly associated with a higher RP Gleason score. Regarding molecular markers of aggressiveness, ADC < 0.80 × 10(-3) mm(2)/s and Likert score >4 were also significantly associated with a positive staining for Ki-67 (P value 0.039 and 0.01, respectively). No association was found between any analyzed MRI or clinical parameter and the CCP score. CONCLUSION: Decreasing ADC value is a stronger indicator of aggressive prostate cancer as defined by molecular markers or postsurgical histology than biopsy characteristics.
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