Correlation between apparent diffusion coefficient value on diffusion-weighted MR imaging and Gleason score in...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Prostate cancer aggressiveness is crucial for treatment decisions.
• Diffusion-weighted imaging (DWI) provides insights into tissue microstructure.
• Apparent diffusion coefficient (ADC) values may reflect tumor cellularity and aggressiveness.

Purpose of the Study:

• To determine if DWI apparent diffusion coefficient (ADC) correlates with prostate cancer aggressiveness.
• To compare the diagnostic performance of ADC and normalized ADC (nADC) in assessing tumor aggressiveness.
• To evaluate ADC and nADC in differentiating between Gleason score 3+4 and 3+3 prostate tumors.

Main Methods:

• Thirty pre-treatment prostate cancer patients underwent MRI with DWI (b values: 50, 400, 800 s/mm²).
• ADC and nADC values (minimum and mean) were calculated for tumors.
• Correlations between ADC/nADC and Gleason scores from biopsy were analyzed.

Main Results:

• Tumor minimum ADC (ADCmin) inversely correlated with Gleason score (r=-0.43, P<0.05).
• ADCmin and nADC values were significantly lower in Gleason score 3+4 than 3+3 tumors (P<0.05).
• Normalized ADC metrics (nADCmin, nADCmean) showed strong correlations with Gleason score (r=-0.52, r=-0.55; P<0.01) and higher diagnostic performance (AUC 0.818-0.833).

Conclusions:

• Tumor ADCmin, nADCmin, and nADCmean are valuable biomarkers for predicting prostate cancer aggressiveness.
• Normalized ADC metrics demonstrate superior performance in differentiating between Gleason score 3+4 and 3+3 tumors.
• DWI-derived ADC and nADC metrics can aid in non-invasively assessing prostate cancer grade.