Utility of computed diffusion‐weighted MRI for predicting aggressiveness of prostate cancer

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  • Yuma Waseda
    Urology Tokyo Medical and Dental University Graduate School Tokyo Japan
  • Soichiro Yoshida
    Urology Tokyo Medical and Dental University Graduate School Tokyo Japan
  • Taro Takahara
    Biomedical Engineering Tokai University School of Engineering Kanagawa Japan
  • Thomas Christian Kwee
    Department of Radiology University Medical Center Groningen Groningen Netherlands
  • Yoh Matsuoka
    Urology Tokyo Medical and Dental University Graduate School Tokyo Japan
  • Kazutaka Saito
    Urology Tokyo Medical and Dental University Graduate School Tokyo Japan
  • Kazunori Kihara
    Urology Tokyo Medical and Dental University Graduate School Tokyo Japan
  • Yasuhisa Fujii
    Urology Tokyo Medical and Dental University Graduate School Tokyo Japan

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<jats:sec><jats:title>Purpose</jats:title><jats:p>To investigate the value of computed (c) diffusion‐weighted imaging (DWI) in assessing prostate cancer aggressiveness.</jats:p></jats:sec><jats:sec><jats:title>Materials and Methods</jats:title><jats:p>Fifty‐five patients with peripheral zone prostate cancer who underwent prebiopsy 1.5T magnetic resonance imaging (including native DWI at <jats:italic>b</jats:italic>‐values of 0 and 1000 s/mm<jats:sup>2</jats:sup>) were included. cDWI signal intensities of peripheral zone prostate cancer and nonmalignant prostate tissue were measured. Association between changes in monoexponentially calculated cDWI signals according to different <jats:italic>b</jats:italic>‐values and primary Gleason grades were assessed.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>The cDWI signal intensity of prostate cancer was lower at <jats:italic>b</jats:italic> = 0 s/mm<jats:sup>2</jats:sup> and higher at <jats:italic>b</jats:italic> = 1000 s/mm<jats:sup>2</jats:sup> compared to nonmalignant prostate tissue. The <jats:italic>b</jats:italic>‐value at which the signal intensities of prostate cancer and nonmalignant prostate tissue were equal was defined as the “iso‐<jats:italic>b</jats:italic>‐value.” On multivariate analysis, only the iso‐<jats:italic>b</jats:italic>‐value was a significant predictor of primary Gleason grade 4/5 cancer (<jats:italic>P</jats:italic> = 0.001). The area under the curve (AUC) of the iso‐<jats:italic>b</jats:italic>‐value for diagnosing primary Gleason grade 4/5 cancer was 0.94, and significantly higher than that of the tumor apparent diffusion coefficient (ADC) value with an AUC of 0.68 (<jats:italic>P</jats:italic> < 0.001).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>cDWI with iso‐<jats:italic>b</jats:italic>‐value‐based semiquantitative analysis was found to be useful for predicting the aggressiveness of prostate cancer and may potentially outperform tumor ADC measurements in this setting.</jats:p></jats:sec><jats:sec><jats:label /><jats:p><jats:bold>Level of Evidence:</jats:bold> 3</jats:p><jats:p><jats:bold>Technical Efficacy</jats:bold>: Stage 2</jats:p><jats:p>J. MAGN. RESON. IMAGING 2017;46:490–496</jats:p></jats:sec>

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