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. 2023 Sep 15;13(9):1378.
doi: 10.3390/jpm13091378.

Quantitative ADC: An Additional Tool in the Evaluation of Prostate Cancer?

Nicola Maria Lucarelli  1 , Ilaria Villanova  1 , Nicola Maggialetti  1 , Sara Greco  1 , Francesca Tarantino  1 , Roberto Russo  1 , Senia Maria Rosaria Trabucco  2 , Amato Antonio Stabile Ianora  1 , Arnaldo Scardapane  1
Affiliations

Quantitative ADC: An Additional Tool in the Evaluation of Prostate Cancer?

Nicola Maria Lucarelli et al. J Pers Med. .

Abstract

Prostate cancer is one of the most common tumors among the male population. Magnetic resonance imaging (MRI), standardized by the PI-RADS version 2.1 scoring system, has a fundamental role in detecting prostate cancer and evaluating its aggressiveness. Diffusion-weighted imaging sequences and apparent diffusion coefficient values, in particular, are considered fundamental for the detection and characterization of lesions. In 2016 the International Society of Urological Pathology introduced a new anatomopathological 5-grade scoring system for prostate cancer. The aim of this study is to evaluate the correlation between quantitative apparent diffusion coefficient values (ADC) derived from diffusion-weighted imaging (DWI) sequences and the International Society of Urological Pathology (ISUP) and PI-RADS groups. Our retrospective study included 143 patients with 154 suspicious lesions, observed on prostate magnetic resonance imaging and compared with the histological results of the biopsy. We observed that ADC values can aid in discriminating between not clinically significant (ISUP 1) and clinically significant (ISUP 2-5) prostate cancers. In fact, ADC values were lower in ISUP 5 lesions than in negative lesions. We also found a correlation between ADC values and PI-RADS groups; we noted lower ADC values in the PI-RADS 5 and PI-RADS 4 groups than in the PI-RADS 3 group. In conclusion, quantitative apparent diffusion coefficient values can be useful to assess the aggressiveness of prostate cancer.

Keywords: ISUP; PIRADS; diffusion-weighted imaging (DWI); magnetic resonance imaging (MRI); prostate cancer; quantitative apparent diffusion coefficient (ADC).

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of inclusion and exclusion criteria.
Figure 2
Figure 2
Percentage of lesions for each PI-RADS group.
Figure 3
Figure 3
Percentage of benign lesions (N) and malignant lesions (ISUP 1–5) based on the anatomopathological results.
Figure 4
Figure 4
Percentage of benign (N) and malignant lesions (ISUP 1–5) in each PI-RADS group.
Figure 5
Figure 5
Scatterplot showing correlation between mean ADC values and benign and ISUP (from 1 to 5) lesions in both peripheral and transition zones.
Figure 6
Figure 6
Scatterplot showing relationship between mean ADC values and benign and ISUP (from 1 to 5) lesions divided into peripheral and transition zones.
Figure 7
Figure 7
Scatterplot showing relationship between mean ADC values in each PI-RADS group (from 3 to 5) in both peripheral and transition zones.
Figure 8
Figure 8
Scatterplot showing relationship between mean ADC values in each PI-RADS group (from 3 to 5) divided in peripheral and transition zones.
Figure 9
Figure 9
ROC curve of the ADC values (A) stratified by tumor zone of origin (B,C). The area under the ROC curve (AUC) suggests that ADC value is a reasonable predictor for differentiating diagnoses of clinically significant prostate cancer.
Figure 10
Figure 10
Examples of ADC values (mm2/s × 10−3) in different zones of the prostate, classified according to different ISUP groups.
See this image and copyright information in PMC

References

    1. Sekhoacha M., Riet K., Motloung P., Gumenku L., Adegoke A., Mashele S. Prostate Cancer Review: Genetics, Diagnosis, Treatment Options, and Alternative Approaches. Molecules. 2022;27:5730. doi: 10.3390/molecules27175730. - DOI - PMC - PubMed
    1. Associazione Italiana di Oncologia Medica . Linee Guida Carcinoma della Prostata: Edizione 2021. Associazione Italiana di Oncologia Medica; Milano, Italy: 2023.
    1. Costa D.N., Xi Y., Aziz M., Passoni N., Shakir N., Goldberg K., Francis F., Roehrborn C.G., Diaz de Leon A., Pedrosa I. Prospective Inclusion of Apparent Diffusion Coefficients in Multiparametric Prostate MRI Structured Reports: Discrimination of Clinically Insignificant and Significant Cancers. Am. J. Roentgenol. 2019;212:109–116. doi: 10.2214/AJR.18.19937. - DOI - PubMed
    1. Rosenkrantz A.B. MRI of the Prostate—A Practical Approach. Thieme; New York, NY, USA: 2017.
    1. Miller D.C., Hafez K.S., Stewart A., Montie J.E., Wei J.T. Prostate carcinoma presentation, diagnosis, and staging: An update form the National Cancer Data Base. Cancer. 2003;98:1169–1178. doi: 10.1002/cncr.11635. - DOI - PubMed