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Utility of computed diffusion‐weighted MRI for predicting aggressiveness of prostate cancer
Author(s) -
Waseda Yuma,
Yoshida Soichiro,
Takahara Taro,
Kwee Thomas Christian,
Matsuoka Yoh,
Saito Kazutaka,
Kihara Kazunori,
Fujii Yasuhisa
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.25593
Subject(s) - prostate cancer , medicine , effective diffusion coefficient , prostate , magnetic resonance imaging , diffusion mri , cancer , nuclear medicine , stage (stratigraphy) , diffusion imaging , radiology , paleontology , biology
Purpose To investigate the value of computed (c) diffusion‐weighted imaging (DWI) in assessing prostate cancer aggressiveness. Materials and Methods Fifty‐five patients with peripheral zone prostate cancer who underwent prebiopsy 1.5T magnetic resonance imaging (including native DWI at b ‐values of 0 and 1000 s/mm 2 ) were included. cDWI signal intensities of peripheral zone prostate cancer and nonmalignant prostate tissue were measured. Association between changes in monoexponentially calculated cDWI signals according to different b ‐values and primary Gleason grades were assessed. Results The cDWI signal intensity of prostate cancer was lower at b = 0 s/mm 2 and higher at b = 1000 s/mm 2 compared to nonmalignant prostate tissue. The b ‐value at which the signal intensities of prostate cancer and nonmalignant prostate tissue were equal was defined as the “iso‐ b ‐value.” On multivariate analysis, only the iso‐ b ‐value was a significant predictor of primary Gleason grade 4/5 cancer ( P = 0.001). The area under the curve (AUC) of the iso‐ b ‐value for diagnosing primary Gleason grade 4/5 cancer was 0.94, and significantly higher than that of the tumor apparent diffusion coefficient (ADC) value with an AUC of 0.68 ( P < 0.001). Conclusion cDWI with iso‐ b ‐value‐based semiquantitative analysis was found to be useful for predicting the aggressiveness of prostate cancer and may potentially outperform tumor ADC measurements in this setting.Level of Evidence: 3 Technical Efficacy : Stage 2 J. MAGN. RESON. IMAGING 2017;46:490–496