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Updated: Dec 20, 2025
A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
Discrimination between clinical significant and insignificant prostate cancer with apparent diffusion coefficient - a
Hans-Jonas Meyer1, Andreas Wienke2, Alexey Surov3
1Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany. Hans-jonas.meyer@medizin.uni-leipzig.de.
Background:
Prostate MRI has become a corner stone in diagnosis of prostate cancer (PC). Diffusion weighted imaging and the apparent diffusion coefficient (ADC) can be used to reflect tumor microstructure. The present analysis sought to compare ADC values of clinically insignificant with clinical significant PC based upon a large patient sample.
Methods:
MEDLINE library and SCOPUS databases were screened for the associations between ADC and Gleason score (GS) in PC up to May 2019. The primary endpoint of the systematic review was the ADC value of PC groups according to Gleason score. In total 26 studies were suitable for the analysis and included into the present study. The included studies comprised a total of 1633 lesions.
Results:
Clinically significant PCs (GS ≥ 7) were diagnosed in 1078 cases (66.0%) and insignificant PCs (GS 5 and 6) in 555 cases (34.0%). The pooled mean ADC value derived from monoexponenantially fitted ADCmean of the clinically significant PC was 0.86 × 10- 3 mm2/s [95% CI 0.83-0.90] and the pooled mean value of insignificant PC was 1.1 × 10- 3 mm2/s [95% CI 1.03-1.18]. Clinical significant PC showed lower ADC values compared to non-significant PC. The pooled ADC values of clinically insignificant PCs were no lower than 0.75 × 10- 3 mm2/s.
Conclusions:
We evaluated the published literature comparing clinical insignificant with clinically prostate cancer in regard of the Apparent diffusion coefficient values derived from magnetic resonance imaging. We identified that the clinically insignificant prostate cancer have lower ADC values than clinically significant, which may aid in tumor noninvasive tumor characterization in clinical routine.
Insights
Clinically significant prostate cancer (PC) shows lower apparent diffusion coefficient (ADC) values than insignificant PC. This finding, based on a systematic review, aids in noninvasive tumor characterization using MRI.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Prostate MRI is crucial for diagnosing prostate cancer (PC).
- Diffusion-weighted imaging and apparent diffusion coefficient (ADC) assess tumor microstructure.
- This study compares ADC values between clinically insignificant and significant PC.
Purpose of the Study:
- To compare apparent diffusion coefficient (ADC) values in clinically insignificant versus clinically significant prostate cancer (PC).
- To evaluate the utility of ADC values in differentiating PC grades for improved noninvasive tumor characterization.
Main Methods:
- Systematic review of MEDLINE and SCOPUS databases for studies on ADC and Gleason score (GS) in PC up to May 2019.
- Included 26 studies with 1633 PC lesions.
- Primary endpoint: pooled mean ADC values stratified by Gleason score.
Main Results:
- Clinically significant PC (GS ≥ 7) comprised 66.0% (1078 lesions), while insignificant PC (GS 5-6) was 34.0% (555 lesions).
- Pooled mean ADC value for significant PC was 0.86 × 10⁻³ mm²/s (CI 0.83-0.90).
- Pooled mean ADC value for insignificant PC was 1.1 × 10⁻³ mm²/s (CI 1.03-1.18), indicating lower ADC in significant PC.
Conclusions:
- Clinically insignificant prostate cancer exhibits lower apparent diffusion coefficient (ADC) values compared to clinically significant PC.
- These ADC value differences can assist in the noninvasive characterization of prostate tumors in clinical practice.
- The findings support the use of MRI-derived ADC values for differentiating PC aggressiveness.
