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Prostate and metastasis diffusion volume based on apparent diffusion coefficient as a prognostic factor in
Motohiro Fujiwara1, Soichiro Yoshida2, Taro Takahara3,4
1Department of Urology, Tokyo Medical and Dental University Graduate School, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan.
Whole-body diffusion-weighted imaging (WB-DWI) shows metastatic diffusion volume (mDV) can predict castration-resistant free survival (CFS) in metastatic hormone-naïve prostate cancer (mHNPC) patients. mDV, particularly with specific apparent diffusion coefficient (ADC) values, serves as a valuable imaging biomarker.
Area of Science:
- Oncology
- Radiology
- Medical Imaging
Background:
- Metastatic hormone-naïve prostate cancer (mHNPC) requires reliable imaging biomarkers for prognosis.
- Whole-body diffusion-weighted imaging (WB-DWI) offers potential for assessing tumor characteristics.
Purpose of the Study:
- To evaluate WB-DWI's utility as an imaging biomarker in mHNPC.
- To assess the association between tumor diffusion volume (DV) and castration-resistant free survival (CFS).
Main Methods:
- Retrospective analysis of WB-DWI data from 62 mHNPC patients.
- Evaluation of prostate (pDV) and metastatic (mDV) diffusion volumes based on apparent diffusion coefficient (ADC) values.
- Association analysis with CFS and multivariate analysis.
Main Results:
- Metastatic diffusion volume (mDV) significantly predicted CFS (HR: 2.75, p=0.022).
- mDV with lower ADC values (0.4-1.0 × 10-3 mm2/s) showed a stronger association with CFS.
- On multivariate analysis, mDV (0.4-1.0 × 10-3 mm2/s) and Gleason grade group were significant predictors of CFS.
Conclusions:
- Metastatic diffusion volume (mDV) derived from WB-DWI is a useful imaging biomarker for predicting CFS in mHNPC patients.
- mDV, especially when considering ADC values, may offer superior prognostic value compared to prostate diffusion volume (pDV).

