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PI-RADS version 2: quantitative analysis aids reliable interpretation of diffusion-weighted imaging for prostate cancer

Authors
 Sung Yoon Park  ;  Su-Jin Shin  ;  Dae Chul Jung  ;  Nam Hoon Cho  ;  Young Deuk Choi  ;  Koon Ho Rha  ;  Sung Joon Hong  ;  Young Taik Oh 
Citation
 EUROPEAN RADIOLOGY, Vol.27(7) : 2776-2783, 2017 
Journal Title
EUROPEAN RADIOLOGY
ISSN
 0938-7994 
Issue Date
2017
MeSH
Aged ; Aged, 80 and over ; Diffusion Magnetic Resonance Imaging/methods* ; Humans ; Male ; Middle Aged ; Neoplasm Staging* ; Prostate/pathology* ; Prostatic Neoplasms/diagnosis* ; Reproducibility of Results ; Retrospective Studies
Keywords
Apparent diffusion coefficient ; Diffusion-weighted imaging ; MRI ; PI-RADS ; Prostate cancer
Abstract
OBJECTIVES: To determine whether apparent diffusion coefficient (ADC) ratio aids reliable interpretation of diffusion-weighted imaging (DWI) for prostate cancer (PCa).

METHODS: Seventy-six consecutive patients with PCa who underwent DWI and surgery were included. Based on pathologic tumour location, two readers independently performed DWI scoring according to the revised Prostate Imaging Reporting and Data System (PI-RADSv2). ADC ratios of benign to cancerous prostatic tissue were then measured independently and compared between cases showing concordant and discordant DWI scores ≥4. Area under the curve (AUC) and threshold of ADC ratio were analyzed for DWI scores ≥4.

RESULTS: The rate of inter-reader disagreement for DWI score ≥4 was 11.8% (9/76). ADC ratios were higher in concordant vs. discordant DWI scores ≥4 (median, 1.7 vs. 1.1-1.2; p < 0.001). For DWI scores ≥4, the AUCs of ADC ratios were 0.970 for reader 1 and 0.959 for reader 2. In patients with an ADC ratio >1.3, the rate of inter-reader disagreement for DWI score ≥4 decreased to 5.9-6.0%. An ADC ratio >1.3 yielded 100% (reader 1, 54/54; reader 2, 51/51) positive predictive value for clinically significant cancer.

CONCLUSION: ADC ratios may be useful for reliable interpretation of DWI score ≥4 in PI-RADSv2.

KEY POINTS: • The ADC ratio correlated positively with DWI score of PI-RADSv2. • ADC ratio >1.3 was associated with concordant interpretation of DWI score ≥4. • ADC ratio >1.3 was associated with high PPV for clinically significant cancer. • ADC ratio is useful for reliable interpretation of DWI scoring in PI-RADSv2.
Full Text
https://link.springer.com/article/10.1007%2Fs00330-016-4678-7
DOI
10.1007/s00330-016-4678-7
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Rha, Koon Ho(나군호) ORCID logo https://orcid.org/0000-0001-8588-7584
Park, Sung Yoon(박성윤)
Shin, Su Jin(신수진) ORCID logo https://orcid.org/0000-0001-9114-8438
Oh, Young Taik(오영택) ORCID logo https://orcid.org/0000-0002-4438-8890
Jung, Dae Chul(정대철) ORCID logo https://orcid.org/0000-0001-5769-5083
Cho, Nam Hoon(조남훈) ORCID logo https://orcid.org/0000-0002-0045-6441
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/160434
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