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Multiparametric MRI Apparent Diffusion Coefficient (ADC) Accuracy in Diagnosing Clinically Significant Prostate

Pietro Pepe¹, Davide D'Urso², Antonio Garufi³

¹Urology Unit, Cannizzaro Hospital, Catania, Italy.

In Vivo (Athens, Greece)

|April 26, 2017

Summary

Multiparametric MRI apparent diffusion coefficient (ADC) accurately diagnoses clinically significant prostate cancer (PCa). ADC values show higher diagnostic accuracy than PI-RADS scores for detecting high-grade PCa.

Keywords:

Multiparametric MRI and prostate cancer apparent diffusion coefficient (ADC)diffusion-weighted imaging (DWI)

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Area of Science:

Radiology
Oncology
Medical Imaging

Background:

Prostate cancer (PCa) diagnosis relies on accurate imaging.
Multiparametric magnetic resonance imaging (mpMRI) is crucial for PCa detection.
Apparent diffusion coefficient (ADC) values quantify tissue water diffusion.

Purpose of the Study:

To assess the diagnostic accuracy of mpMRI ADC values for clinically significant PCa.
To compare ADC values with the Prostate Imaging Reporting and Data System (PI-RADS) for PCa grading.

Main Methods:

Retrospective analysis of 44 patients undergoing radical prostatectomy.
Evaluation of mpMRI ADC values and PI-RADS scores against definitive pathology.
Receiver operating characteristic (ROC) curve analysis to determine diagnostic thresholds.

Main Results:

An ADC threshold of 0.747×10⁻³ mm²/s differentiated Gleason score 6 from ≥7.
ADC values achieved 84% diagnostic accuracy (AUC 0.81) for Gleason score ≥7.
PI-RADS ≥3 showed 63.6% accuracy (AUC 0.71) for Gleason score ≥7.

Conclusions:

ADC evaluation demonstrates superior accuracy in diagnosing clinically significant PCa compared to PI-RADS.
ADC values can aid clinicians in managing patients with PI-RADS scores <3 who are at risk for PCa.