Correlations between Apparent Diffusion Coefficient and Gleason Score in Prostate Cancer: A Systematic Review

2020 ◽  
Vol 3 (4) ◽  
pp. 489-497 ◽  
Author(s):  
Alexey Surov ◽  
Hans Jonas Meyer ◽  
Andreas Wienke
2020 ◽  
Author(s):  
Hans-Jonas Meyer ◽  
Andreas Wienke ◽  
Alexey Surov

Abstract Background Multiparametric MRI has become a corner stone in diagnosis of prostate cancer (PC). Diffusion weighted imaging and the apparent diffusion coefficient (ADC) can be used to reflect tumor microstructure. The present analysis sought to compare ADC values of clinically insignificant with clinical significant PC based upon a large patient sample. Methods MEDLINE library and SCOPUS databases were screened for the associations between ADC and Gleason score in PC up to May 2019. The primary endpoint of the systematic review was the ADC value of PC groups according to Gleason score. In total 27 studies were suitable for the analysis and included into the present study. The included studies comprised a total of 1633 lesions. Results Clinically relevant PCs (Gleason score 7 and higher) were diagnosed in 1078 cases (66.0%) and insignificant PCs (Gleason score 5 and 6) in 555 cases (34.0%). The pooled mean ADC value of the clinically significant PC was 0.86x10-3 mm2/s [95% CI 0.83-0.90] and the pooled mean value of insignificant PC was 1.1 x10-3 mm2/s [95% CI 1.03-1.18]. Clinical significant PC showed lower ADC values compared to non-significant PC. The pooled ADC values of clinically insignificant PCs were no lower than 0.75 ×10-3 mm2/s. This value may be proposed as a threshold for distinguishing clinically significant from insignificant PCs. Conclusions We evaluated the published literature comparing clinical insignificant with clinically prostate cancer in regard of the Apparent diffusion coefficient values derived from magnetic resonance imaging. We identified that the clinically insignificant prostate cancer have lower ADC values than clinically significant, which may aid in tumor noninvasive tumor characterization in clinical routine.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Shayan Sirat Maheen Anwar ◽  
Zahid Anwar Khan ◽  
Rana Shoaib Hamid ◽  
Fahd Haroon ◽  
Raza Sayani ◽  
...  

Purpose. To determine association between apparent diffusion coefficient value on diffusion-weighted imaging and Gleason score in patients with prostate cancer. Methods. This retrospective case series was conducted at Radiology Department of Aga Khan University between June 2009 and June 2011. 28 patients with biopsy-proven prostate cancer were included who underwent ultrasound guided sextant prostate biopsy and MRI. MRI images were analyzed on diagnostic console and regions of interest were drawn. Data were entered and analyzed on SPSS 20.0. ADC values were compared with Gleason score using one-way ANOVA test. Results. In 28 patients, 168 quadrants were biopsied and 106 quadrants were positive for malignancy. 89 lesions with proven malignancy showed diffusion restriction. The mean ADC value for disease with a Gleason score of 6 was 935 mm2/s (SD=248.4 mm2/s); Gleason score of 7 was 837 mm2/s (SD=208.5 mm2/s); Gleason score of 8 was 614 mm2/s (SD=108 mm2/s); and Gleason score of 9 was 571 mm2/s (SD=82 mm2/s). Inverse relationship was observed between Gleason score and mean ADC values. Conclusion. DWI and specifically quantitative ADC values may help differentiate between low-risk (Gleason score, 6), intermediate-risk (Gleason score, 7), and high-risk (Gleason score 8 and 9) prostate cancers, indirectly determining the aggressiveness of the disease.


2018 ◽  
Vol 10 (12) ◽  
pp. 359-364
Author(s):  
Andrew McPartlin ◽  
Lucy Kershaw ◽  
Alan McWilliam ◽  
Marcus Ben Taylor ◽  
Clare Hodgson ◽  
...  

Background: Changes in prostate cancer apparent diffusion coefficient (ADC) derived from diffusion-weighted magnetic resonance imaging (MRI) provide a noninvasive method for assessing radiotherapy response. This may be attenuated by neoadjuvant hormone therapy (NA-HT). We investigate ADC values measured before, during and after external beam radiotherapy (EBRT) following NA-HT. Methods: Patients with ⩾T2c biopsy-proven prostate cancer receiving 3 months of NA-HT plus definitive radiotherapy were prospectively identified. All underwent ADC-MRI scans in the week before EBRT, in the third week of EBRT and 8 weeks after its completion. Imaging was performed at 1.5 T. The tumour, peripheral zone (PZ) and central zone (CZ) of the prostate gland were identified and median ADC calculated for each region and time point. Results: Between September and December 2014, 15 patients were enrolled (median age 68.3, range 57–78) with a median Gleason score of 7 (6–9) and prostate-specific antigen (PSA) at diagnosis 14 (3–197) ng/ml. Median period of NA-HT prior to first imaging was 96 days (69–115). All patients completed treatment. Median follow up was 25 months (7–34), with one patient relapsing in this time. Thirteen patients completed all imaging as intended, one withdrew after one scan and another missed the final imaging. PZ and CZ could not be identified in one patient. Median tumour ADC before, during and post radiotherapy was 1.24 × 10−3 mm2/s (interquartile range 0.16 × 10−3 mm2/s), 1.31 × 10−3 mm2/s (0.22 × 10−3 mm2/s), then 1.32 × 10−3 mm2/s (0.13 × 10−3 mm2/s) respectively ( p > 0.05). There was no significant difference between median tumour and PZ or CZ ADC at any point. Gleason score did not correlate with ADC values. Conclusions: Differences in ADC parameters of normal and malignant tissue during EBRT appear attenuated by prior NA-HT. The use of changes in ADC as a predictive tool in this group may have limited utility.


2014 ◽  
Vol 42 (2) ◽  
pp. 446-453 ◽  
Author(s):  
Lars Boesen ◽  
Elizaveta Chabanova ◽  
Vibeke Løgager ◽  
Ingegerd Balslev ◽  
Henrik S. Thomsen

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