Related Experiment Video
Updated: Aug 18, 2025
Tracking the Mammary Architectural Features and Detecting Breast Cancer with Magnetic Resonance Diffusion Tensor Imaging
Published on: December 15, 2014
MRI-Derived Apparent Diffusion Coefficient of Peri-Prostatic Adipose Tissue Is a Potential Determinant of Prostate
Alessandro Tafuri1, Andrea Panunzio2, Federico Greco3
1Department of Urology, "Vito Fazzi" Hospital, Piazza Filippo Muratore, 1, 73100 Lecce, Italy.
Abstract:
Background: The aim of this study was to test the association between periprostatic adipose tissue (PPAT)—apparent diffusion coefficient (ADC) value recorded at multiparametric magnetic resonance imaging (mpMRI) and determinants of prostate cancer (PCa) aggressiveness in the preoperative setting. Methods: Data from 219 consecutive patients undergoing prostate biopsy (PBx) for suspicion of PCa, between January 2020 and June 2022, at our institution were retrospectively evaluated. Only patients who had mpMRI performed before PBx were included. The distribution of demographics and clinical features among PPAT-ADC values up to vs. above the median was studied using both parametric and non-parametric tests, according to variables. Linear and logistic regression models tested the association between PPAT-ADC values and determinants of PCa aggressiveness and the presence of intermediate-high risk PCa, respectively. Results: Of 132 included patients, 76 (58%) had PCa. Median PPAT-ADC was 876 (interquartile range: 654 − 1112) × 10−6 mm2/s. Patients with PPAT-ADC up to the median had a higher rate of PIRADS (Prostate Imaging—Reporting and Data System) 5 lesions (41% vs. 23%, p = 0.032), a higher percentage of PBx positive cores (25% vs. 6%, p = 0.049) and more frequently harbored ISUP (International Society of Urological Pathology) > 1 PCa (50% vs. 28%, p = 0.048). At univariable linear regression analyses, prostate-specific antigen (PSA), PSA density, PIRADS 5, and percentage of PBx positive cores were associated with lower PPAT-ADC values. PPAT-ADC up to the median was an independent predictor for intermediate-high risk PCa (odds ratio: 3.24, 95%CI: 1.17−9.46, p = 0.026) after adjustment for age and body mass index. Conclusions: Lower PPAT-ADC values may be associated with higher biopsy ISUP grade group PCa and a higher percentage of PBx-positive cores. Higher-level studies are needed to confirm these preliminary results.
Insights
Lower periprostatic adipose tissue (PPAT) apparent diffusion coefficient (ADC) values on multiparametric MRI may indicate more aggressive prostate cancer (PCa). This finding suggests PPAT-ADC could help predict PCa risk before biopsy.
Area of Science:
- Radiology and Imaging
- Urology
- Oncology
Background:
- Multiparametric magnetic resonance imaging (mpMRI) is crucial for prostate cancer (PCa) detection.
- Periprostatic adipose tissue (PPAT) is adjacent to the prostate and may reflect tumor characteristics.
- Apparent diffusion coefficient (ADC) values quantify water molecule diffusion, potentially indicating tissue cellularity and aggressiveness.
Purpose of the Study:
- To investigate the association between preoperative PPAT-ADC values from mpMRI and indicators of prostate cancer aggressiveness.
- To determine if PPAT-ADC can predict the presence of intermediate-high risk prostate cancer before biopsy.
Main Methods:
- Retrospective analysis of 132 patients with suspected prostate cancer who underwent mpMRI before prostate biopsy (PBx).
- PPAT-ADC values were measured and compared between patients with PCa and those without, and stratified by median PPAT-ADC.
- Statistical analyses, including linear and logistic regression, assessed the relationship between PPAT-ADC and PCa aggressiveness determinants (e.g., PIRADS, ISUP grade, positive biopsy cores).
Main Results:
- Fifty-eight percent (76/132) of patients had PCa.
- Lower PPAT-ADC values (≤ median) were significantly associated with higher PIRADS 5 lesion rates, increased percentage of positive biopsy cores, and higher ISUP grade group PCa (ISUP > 1).
- Lower PPAT-ADC was an independent predictor of intermediate-high risk PCa after adjusting for age and BMI.
Conclusions:
- Lower PPAT-ADC values on mpMRI may correlate with more aggressive prostate cancer, indicated by higher ISUP grade and more positive biopsy cores.
- PPAT-ADC shows potential as a preoperative imaging biomarker for predicting PCa aggressiveness.
- Further large-scale studies are required to validate these preliminary findings.
