Simpa S Salami1, Eran Ben-Levi2, Oksana Yaskiv3, Baris Turkbey4, Robert Villani2, Ardeshir R Rastinehad5. 1. Department of Urology, University of Michigan Medical School, Ann Arbor, Michigan, USA. 2. Department of Radiology, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, New York, USA. 3. Department of Pathology, Hofstra North Shore-LIJ School of Medicine, New Hyde Park, New York, USA. 4. Molecular Imaging Program, National Institutes of Health, Bethesda, Maryland, USA. 5. Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Abstract
PURPOSE: To evaluate the performance of apparent diffusion coefficient (ADC) and lesion volume in potentially risk-stratifying patients with prostate cancer (PCa). MATERIALS AND METHODS: Men with elevated prostate-specific antigen or abnormal digital rectal exam underwent a 3T multiparametric magnetic resonance imaging (mpMRI) with endorectal coil. ADC maps were calculated using b values of 0, 500, 1000, and 1500; additional images were obtained with b value of 2000. We prospectively enrolled 312 men with lesions suspicious for cancer (suspicion score 2-5) on mpMRI. MRI/ultrasound fusion-guided prostate biopsies were performed. Mean ADC of suspicious lesions were correlated against lesion volume, Gleason and D'Amico risk. RESULTS: The cancer detection rate of fusion biopsy per lesion was 45.6% (206/452). Cancerous lesions were larger (median volume: 0.40 vs. 0.30 cm3 ; P = 0.016). The median ADC (×10-6 mm2 /sec) for lesions negative and positive for PCa were 984.5 and 666.5, respectively (P < 0.0001). The AUC of ADC in predicting PCa was 0.79. Larger lesions were associated with higher risk PCa (Gleason and D'Amico) and lower ADC (all P < 0.0001). CONCLUSION: The mean ADC of suspicious lesions on mpMRI was inversely correlated, while lesion volume had a direct correlation with PCa detection. Future follow-up studies are needed to assess longitudinal cancer risks of suspicious mpMRI lesions. LEVEL OF EVIDENCE: 2 J. Magn. Reson. Imaging 2017;45:610-616.
PURPOSE: To evaluate the performance of apparent diffusion coefficient (ADC) and lesion volume in potentially risk-stratifying patients with prostate cancer (PCa). MATERIALS AND METHODS:Men with elevated prostate-specific antigen or abnormal digital rectal exam underwent a 3T multiparametric magnetic resonance imaging (mpMRI) with endorectal coil. ADC maps were calculated using b values of 0, 500, 1000, and 1500; additional images were obtained with b value of 2000. We prospectively enrolled 312 men with lesions suspicious for cancer (suspicion score 2-5) on mpMRI. MRI/ultrasound fusion-guided prostate biopsies were performed. Mean ADC of suspicious lesions were correlated against lesion volume, Gleason and D'Amico risk. RESULTS: The cancer detection rate of fusion biopsy per lesion was 45.6% (206/452). Cancerous lesions were larger (median volume: 0.40 vs. 0.30 cm3 ; P = 0.016). The median ADC (×10-6 mm2 /sec) for lesions negative and positive for PCa were 984.5 and 666.5, respectively (P < 0.0001). The AUC of ADC in predicting PCa was 0.79. Larger lesions were associated with higher risk PCa (Gleason and D'Amico) and lower ADC (all P < 0.0001). CONCLUSION: The mean ADC of suspicious lesions on mpMRI was inversely correlated, while lesion volume had a direct correlation with PCa detection. Future follow-up studies are needed to assess longitudinal cancer risks of suspicious mpMRI lesions. LEVEL OF EVIDENCE: 2 J. Magn. Reson. Imaging 2017;45:610-616.
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