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Published on: March 21, 2025
Correlation of MRI-Derived Apparent Diffusion Coefficient (ADC) Values With Gleason Scores in Prostate Cancer and
Victoria Y Bird1,2, Krystina Masihy1, Juan Varela3
1Urology, National Medical Association and Research Group, Gainesville, USA.
Background:
Accurate characterization of prostate cancer (PCa) aggressiveness remains a clinical challenge. While multiparametric MRI (mpMRI) and Prostate Imaging Reporting and Data System (PI-RADS) scoring are widely used, their qualitative nature introduces inter-reader variability. Apparent diffusion coefficient (ADC) values derived from diffusion-weighted imaging (DWI) may provide a more objective biomarker of tumor severity.
Methods:
We retrospectively analyzed 181 lesions from 101 patients with biopsy-proven PCa (2019-2025). The lowest or minimum ADC (ADCmin) value (µm2/s) was recorded for each lesion and correlated with Gleason scores: low-risk (3+3), intermediate-favorable (3+4), intermediate-unfavorable (4+3), and high-risk (≥4+4). Statistical analysis was performed using Welch's analysis of variance (ANOVA) with Games-Howell post hoc testing.
Results:
Mean ADC values showed a progressive decline with increasing Gleason category: 3+3 = 456.5 ± 191 µm2/s; 3+4 = 382.0 ± 188 µm2/s; 4+3 = 296.2 ± 130 µm2/s; ≥4+4 = 222.6 ± 134 µm2/s. Interquartile ranges (IQRs) similarly decreased across categories. Welch's ANOVA demonstrated significant overall group differences (F(3, 84.78) = 18.95, p < 0.001). Games-Howell post hoc tests revealed significantly lower ADC values in 4+3 and ≥4+4 compared with 3+3 (p < 0.001) and in ≥4+4 compared with 3+4 (p < 0.001).
Conclusion:
MRI-derived ADC values inversely correlate with Gleason scores, suggesting their potential as a non-invasive biomarker for PCa aggressiveness. Incorporating ADC values into clinical workflows may enhance biopsy targeting, risk stratification, and treatment planning.
Insights
Apparent diffusion coefficient (ADC) values from MRI show a significant inverse correlation with prostate cancer Gleason scores. Lower ADC values indicate more aggressive tumors, offering a potential objective biomarker for clinical use.
Area of Science:
- Radiology and Oncology
- Biomedical Imaging
- Prostate Cancer Research
Background:
- Characterizing prostate cancer (PCa) aggressiveness is challenging.
- Multiparametric MRI (mpMRI) and PI-RADS scoring have limitations due to inter-reader variability.
- Apparent diffusion coefficient (ADC) values from diffusion-weighted imaging (DWI) offer a potential objective biomarker for tumor severity.
Purpose of the Study:
- To investigate the correlation between ADC values and Gleason scores in PCa.
- To assess the potential of ADC as a non-invasive biomarker for PCa aggressiveness.
Main Methods:
- Retrospective analysis of 181 PCa lesions from 101 patients.
- Recorded minimum ADC (ADCmin) values and correlated them with Gleason scores (3+3, 3+4, 4+3, ≥4+4).
- Statistical analysis using Welch's ANOVA and Games-Howell post hoc tests.
Main Results:
- Mean ADC values progressively decreased with increasing Gleason scores.
- Significant differences in ADC values were found across Gleason categories (p < 0.001).
- Specifically, higher-risk Gleason categories (4+3 and ≥4+4) had significantly lower ADC values compared to lower-risk categories.
Conclusions:
- MRI-derived ADC values inversely correlate with PCa Gleason scores.
- ADC values show potential as a non-invasive biomarker for PCa aggressiveness.
- Integrating ADC into clinical workflows may improve biopsy targeting, risk stratification, and treatment planning.
