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Diffusion-weighted imaging predicts upgrading of Gleason score in biopsy-proven low grade prostate cancers

 Sung Yoon Park  ;  Young Taik Oh  ;  Dae Chul Jung  ;  Nam Hoon Cho  ;  Young Deuk Choi  ;  Koon Ho Rha  ;  Sung Joon Hong 
 BJU International, Vol.119(1) : 57-66, 2017 
Journal Title
 BJU International 
Issue Date
Adult ; Aged ; Biopsy ; Diffusion Magnetic Resonance Imaging* ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Predictive Value of Tests ; Prostate/diagnostic imaging* ; Prostate/pathology* ; Prostatic ; Neoplasms/diagnostic imaging* ; Prostatic Neoplasms/pathology* ; Retrospective Studies
Gleason score ; diffusion-weighted imaging ; prostate cancer ; upgrading
OBJECTIVE: To analyse whether diffusion-weighted imaging (DWI) predicts Gleason score (GS) upgrading in biopsy-proven low grade prostate cancer (PCa). PATIENTS AND METHODS: A total of 132 patients who had biopsy-proven low grade (GS < 7) PCa, 3T DWI results, and surgical confirmation were retrospectively included in the study. Clinical variables (prostate-specific antigen, greatest percentage of cancer in a biopsy core and percentage of positive cores) and DWI variables (minimum apparent diffusion coefficient [ADCmin ] and mean ADC [ADCmean ]) were evaluated. ADCmin was measured, by two independent, blinded readers, using a region of interest (ROI) of 5-10 mm2 at the area of lowest ADC value within a cancer, while ADCmean was measured using an ROI covering more than half of a cancer. Logistic regression and receiver-operating characteristic curve analyses were performed. RESULTS: The rate of GS upgrading was 46.1% (61/132). In both univariate and multivariate analyses, ADCmin and ADCmean were persistently significant for predicting GS upgrading (P < 0.05), whereas clinical variables were not (P > 0.05). In both readers' results, the area under the curve (AUC) of ADCmin was significantly greater than that of ADCmean (reader 1: AUC 0.760 vs 0.711; P < 0.001; reader 2: AUC 0.752 vs 0.714; P = 0.003). CONCLUSION: Our results showed that DWI may predict GS upgrading of biopsy-proven low grade PCa. The variable ADCmin in PCa may perform better than ADCmean .
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1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
나군호(Rha, Koon Ho) ORCID logo https://orcid.org/0000-0001-8588-7584
박성윤(Park, Sung Yoon)
오영택(Oh, Young Taik) ORCID logo https://orcid.org/0000-0002-4438-8890
정대철(Jung, Dae Chul) ORCID logo https://orcid.org/0000-0001-5769-5083
조남훈(Cho, Nam Hoon) ORCID logo https://orcid.org/0000-0002-0045-6441
최영득(Choi, Young Deuk) ORCID logo https://orcid.org/0000-0002-8545-5797
홍성준(Hong, Sung Joon) ORCID logo https://orcid.org/0000-0001-9869-065X
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