Objectives: To investigate whether diffusion-weighted imaging (DWI) apparent diffusion coefficient (ADC) correlates with prostate cancer aggressiveness and further to compare the diagnostic performance of ADC and normalized ADC (nADC: normalized to non-tumor tissue).
Patients And Methods: Thirty pre-treatment patients (mean age, 69years; range: 59-78years) with prostate cancer underwent magnetic resonance imaging (MRI) examination, including DWI with three b values: 50, 400, and 800s/mm. Both ADC and nADC were correlated with the Gleason score obtained through transrectal ultrasound-guided biopsy.
Results: The tumor minimum ADC (ADC: the lowest ADC value within tumor) had an inverse correlation with the Gleason score (r=-0.43, P<0.05), and it was lower in patients with Gleason score 3+4 than in those with Gleason score 3+3 (0.54±0.11×10mm/s vs. 0.64±0.12×10mm/s, P<0.05). Both the nADC and nADC correlated with the Gleason score (r=-0.52 and r=-0.55, P<0.01; respectively), and they were lower in patients with Gleason score 3+4 than those with Gleason score 3+3 (P<0.01; respectively). Receiver operating characteristic (ROC) analysis showed that the area under the ROC curve was 0.765, 0.818, or 0.833 for the ADC, nADC, or nADC; respectively, in differentiating between Gleason score 3+4 and 3+3 tumors.
Conclusion: Tumor ADC, nADC, and nADC are useful markers to predict the aggressiveness of prostate cancer.
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