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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.
Aim:
To evaluate the accuracy of multiparametric magnetic resonance imaging apparent diffusion coefficient (mpMRI ADC) in the diagnosis of clinically significant prostate cancer (PCa).
Patients And Methods:
From January 2016 to December 2016, 44 patients who underwent radical prostatectomy for PCa and mpMRI lesions suggestive of cancer were retrospectively evaluated at definitive specimen. The accuracy of suspicious mpMRI prostate imaging reporting and data system (PI-RADS ≥3) vs. ADC values in the diagnosis of Gleason score ≥7 was evaluated.
Results:
Receiver operating characteristics (ROC) curve analysis gave back an ADC threshold of 0.747×10-3 mm2/s to separate between Gleason Score 6 and ≥7. The diagnostic accuracy of ADC value (cut-off 0.747×10-3 mm2/s) vs. PI-RADS score ≥3 in diagnosing PCa with Gleason score ≥7 was equal to 84% vs. 63.6% with an area under the curve (AUC) ROC of 0.81 vs. 0.71, respectively.
Conclusion:
ADC evaluation could support clinicians in decision making of patients with PI-RADS score <3 at risk for PCa.
Insights
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.
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.
