scholarly journals Discrimination between clinical significant and insignificant prostate cancer with Apparent diffusion coefficient – A systematic review and meta analysis

2020 ◽  
Author(s):  
Hans-Jonas Meyer ◽  
Andreas Wienke ◽  
Alexey Surov
Keyword(s):  
Prostate Cancer ◽  
Systematic Review ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Gleason Score ◽  
Adc Value ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Clinically Significant ◽  
Insignificant Prostate Cancer

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.

scholarly journals Assessment of Apparent Diffusion Coefficient Values as Predictor of Aggressiveness in Peripheral Zone Prostate Cancer: Comparison with Gleason Score

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Shayan Sirat Maheen Anwar ◽  
Zahid Anwar Khan ◽  
Rana Shoaib Hamid ◽  
Fahd Haroon ◽  
Raza Sayani ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Gleason Score ◽  
Case Series ◽  
Adc Value ◽  
Apparent Diffusion Coefficient Values ◽  
Apparent Diffusion Coefficient Value ◽  
Apparent Diffusion ◽  
Adc Values

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.

scholarly journals Changes in prostate apparent diffusion coefficient values during radiotherapy after neoadjuvant hormones

2018 ◽  
Vol 10 (12) ◽  
pp. 359-364
Author(s):  
Andrew McPartlin ◽  
Lucy Kershaw ◽  
Alan McWilliam ◽  
Marcus Ben Taylor ◽  
Clare Hodgson ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Gleason Score ◽  
Prostate Gland ◽  
Specific Antigen ◽  
Predictive Tool ◽  
Significant Difference ◽  
Apparent Diffusion ◽  
Adc Values

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.

Impact of mandated prospectively reported apparent diffusion coefficient values on the rates of positivity for clinically significant prostate cancer by PI-RADS score

2020 ◽  
pp. 028418512091561
Author(s):  
Hiram Shaish ◽  
Randy Casals ◽  
Firas Ahmed ◽  
Jasnit Makkar ◽  
Sven Wenske
Keyword(s):  
Prostate Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Chi Square ◽  
Apparent Diffusion Coefficient Values ◽  
Apparent Diffusion ◽  
Adc Values ◽  
Clinically Significant ◽  
Magnetic Resonance Imaging Mri ◽  
The Impact

Background Prior research has shown that retrospectively measured apparent diffusion coefficient (ADC) of prostate magnetic resonance imaging (MRI) lesions is associated with clinically significant prostate cancer (csPCa) on targeted biopsy suggesting that ADC should be measured and reported prospectively. Purpose To assess the impact of mandatory prospective measurement of ADC on the rates of positivity across PI-RADS scores for csPCa. Material and Methods Consecutive patients who underwent ultrasound (US)-MRI fusion prostate biopsy from August 2018 to July 2019 and who had prospectively reported ADC were compared to control patients who did not. Rates of positivity by PI-RADS category were computed and compared using Chi-square. Multivariable regression was performed. Results In total, 126 patients (median age 65 years) with 165 prostate lesions (19, 51, 70, and 25 PI-RADS 2, 3, 4, and 5, respectively) and prospectively reported ADC values were compared to 113 control patients (median age 66 years) with 157 prostate lesions (17, 42, 64, and 34 PI-RADS 2, 3, 4, and 5, respectively). Rates of positivity across PI-RADS scores were similar between the two cohorts; 11%, 25%, 55%, and 76% and 0%, 21%, 56%, and 62% for PI-RADS 2, 3, 4, and 5 in the test and control cohorts, respectively (Chi-square P = 0.78). Multivariate logistic regression showed no significant association between the presence of prospectively measured ADC and csPCa (odds ratio 1.1, 95% confidence interval 0.7–1.7, P = 0.82). Conclusion Prospective ADC measurement may not impact PI-RADS category assignments or positivity rates for csPCa under current guidelines. Future versions of PI-RADS may need to incorporate ADC into scoring rules to realize their potential.

scholarly journals Apparent diffusion coefficient cannot discriminate metastatic and non-metastatic lymph nodes in rectal cancer: a meta-analysis

2021 ◽  
Author(s):  
Alexey Surov ◽  
Hans-Jonas Meyer ◽  
Maciej Pech ◽  
Maciej Powerski ◽  
Jasan Omari ◽  
...  
Keyword(s):  
Rectal Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Lymph Nodes ◽  
Meta Analysis ◽  
Adc Value ◽  
Metastatic Lymph Nodes ◽  
Metastatic Lymph ◽  
Apparent Diffusion ◽  
Adc Values

Abstract Background Our aim was to provide data regarding use of diffusion-weighted imaging (DWI) for distinguishing metastatic and non-metastatic lymph nodes (LN) in rectal cancer. Methods MEDLINE library, EMBASE, and SCOPUS database were screened for associations between DWI and metastatic and non-metastatic LN in rectal cancer up to February 2021. Overall, 9 studies were included into the analysis. Number, mean value, and standard deviation of DWI parameters including apparent diffusion coefficient (ADC) values of metastatic and non-metastatic LN were extracted from the literature. The methodological quality of the studies was investigated according to the QUADAS-2 assessment. The meta-analysis was undertaken by using RevMan 5.3 software. DerSimonian, and Laird random-effects models with inverse-variance weights were used to account the heterogeneity between the studies. Mean DWI values including 95% confidence intervals were calculated for metastatic and non-metastatic LN. Results ADC values were reported for 1376 LN, 623 (45.3%) metastatic LN, and 754 (54.7%) non-metastatic LN. The calculated mean ADC value (× 10−3 mm2/s) of metastatic LN was 1.05, 95%CI (0.94, 1.15). The calculated mean ADC value of the non-metastatic LN was 1.17, 95%CI (1.01, 1.33). The calculated sensitivity and specificity were 0.81, 95%CI (0.74, 0.89) and 0.67, 95%CI (0.54, 0.79). Conclusion No reliable ADC threshold can be recommended for distinguishing of metastatic and non-metastatic LN in rectal cancer.

Influence of menstrual status and pathological type on the apparent diffusion coefficient in cervical cancer: a primary study

2020 ◽  
pp. 028418512092689
Author(s):  
Yue Dong ◽  
Rui Tong Dong ◽  
Xiao Miao Zhang ◽  
Qing Ling Song ◽  
Tao Yu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Diffusion Coefficient ◽  
Apparent Diffusion Coefficient ◽  
Primary Study ◽  
Adc Value ◽  
Cervical Cancers ◽  
Menstrual Status ◽  
Pathological Type ◽  
Apparent Diffusion ◽  
Adc Values

Background Apparent diffusion coefficient (ADC) value is an important quantitative parameter in the research of cervical cancer, affected by some factors. Purpose To investigate the effect of pathological type and menstrual status on the ADC value of cervical cancer. Material and Methods A total of 352 individuals with pathologically confirmed cervical cancer between January 2015 to December 2017 were retrospectively enrolled in this study, including 317 cases with squamous cell carcinomas (SCC) and 35 cases with adenocarcinomas (AC); 177 patients were non-menopausal and 175 were menopausal. All patients underwent a routine 3.0-T magnetic resonance imaging (MRI) scan and diffusion-weighted imaging (DWI) examination using b-values of 0, 800, and 1000 s/mm2. Three parameters including mean ADC (ADCmean), maximum ADC (ADCmax), and minimum ADC (ADCmin) of cervical cancer lesions were measured and retrospectively analyzed. Independent samples t-test was used to compare the difference of ADC values in different menstrual status and pathological types. Results In all menopausal and non-menopausal patients, the ADCmean and ADCmin values of SCC were lower than those of AC ( P<0.05), the ADCmax of two pathological types showed no statistical difference ( P > 0.05). In menopausal patients, the ADCmean, ADCmax, and ADCmin values of SCC were not statistically different compared with those of AC ( P > 0.05). The ADCmean, ADCmax, and ADCmin values of different pathological types cervical cancers in non-menopausal patients were all higher than those in menopausal patients ( P<0.05). Conclusion The ADC values of the cervical cancers were different in different pathological types and were also affected by menstrual status.

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