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Risk stratification of prostate cancer utilizing apparent diffusion coefficient value and lesion volume on multiparametric MRI
Author(s) -
Salami Simpa S.,
BenLevi Eran,
Yaskiv Oksana,
Turkbey Baris,
Villani Robert,
Rastinehad Ardeshir R.
Publication year - 2017
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.25363
Subject(s) - effective diffusion coefficient , prostate cancer , medicine , multiparametric mri , risk stratification , prostate , radiology , magnetic resonance imaging , diffusion mri , volume (thermodynamics) , nuclear medicine , cancer , physics , quantum mechanics
Purpose To evaluate the performance of apparent diffusion coefficient (ADC) and lesion volume in potentially risk‐stratifying patients with prostate cancer (PCa). Materials and Methods Men with elevated prostate‐specific antigen or abnormal digital rectal exam underwent a 3T multiparametric magnetic resonance imaging (mpMRI) with endorectal coil. ADC maps were calculated using b values of 0, 500, 1000, and 1500; additional images were obtained with b value of 2000. We prospectively enrolled 312 men with lesions suspicious for cancer (suspicion score 2–5) on mpMRI. MRI/ultrasound fusion‐guided prostate biopsies were performed. Mean ADC of suspicious lesions were correlated against lesion volume, Gleason and D'Amico risk. Results The cancer detection rate of fusion biopsy per lesion was 45.6% (206/452). Cancerous lesions were larger (median volume: 0.40 vs. 0.30 cm 3 ; P = 0.016). The median ADC (×10 −6 mm 2 /sec) for lesions negative and positive for PCa were 984.5 and 666.5, respectively ( P < 0.0001). The AUC of ADC in predicting PCa was 0.79. Larger lesions were associated with higher risk PCa (Gleason and D'Amico) and lower ADC (all P < 0.0001). Conclusion The mean ADC of suspicious lesions on mpMRI was inversely correlated, while lesion volume had a direct correlation with PCa detection. Future follow‐up studies are needed to assess longitudinal cancer risks of suspicious mpMRI lesions. Level of Evidence: 2 J. Magn. Reson. Imaging 2017;45:610–616.