Urology - Original Paper

International Urology and Nephrology

, Volume 46, Issue 3, pp 555-561

First online:

Apparent diffusion coefficient value as a biomarker reflecting morphological and biological features of prostate cancer

  • Hyeyeol BaeAffiliated withDepartment of Urology, Graduate School, Tokyo Medical and Dental University
  • , Soichiro YoshidaAffiliated withDepartment of Urology, Graduate School, Tokyo Medical and Dental University Email author 
  • , Yoh MatsuokaAffiliated withDepartment of Urology, Graduate School, Tokyo Medical and Dental University
  • , Hiroshi NakajimaAffiliated withDepartment of Pathology, Tokyo Medical and Dental University Graduate School
  • , Eisaku ItoAffiliated withDepartment of Pathology, Tokyo Medical and Dental University Graduate School
  • , Hiroshi TanakaAffiliated withDepartment of Radiology, Ochanomizu Surugadai Clinic
  • , Miyako OyaAffiliated withDepartment of Urology, Graduate School, Tokyo Medical and Dental University
  • , Takayuki NakayamaAffiliated withDepartment of Urology, Graduate School, Tokyo Medical and Dental University
  • , Hideki TakeshitaAffiliated withDepartment of Urology, Graduate School, Tokyo Medical and Dental University
    • , Toshiki KijimaAffiliated withDepartment of Urology, Graduate School, Tokyo Medical and Dental University
    • , Junichiro IshiokaAffiliated withDepartment of Urology, Graduate School, Tokyo Medical and Dental University
    • , Noboru NumaoAffiliated withDepartment of Urology, Graduate School, Tokyo Medical and Dental University
    • , Fumitaka KogaAffiliated withDepartment of Urology, Graduate School, Tokyo Medical and Dental University
    • , Kazutaka SaitoAffiliated withDepartment of Urology, Graduate School, Tokyo Medical and Dental University
    • , Takumi AkashiAffiliated withDepartment of Pathology, Tokyo Medical and Dental University Graduate School
    • , Yasuhisa FujiiAffiliated withDepartment of Urology, Graduate School, Tokyo Medical and Dental University
    • , Kazunori KiharaAffiliated withDepartment of Urology, Graduate School, Tokyo Medical and Dental University

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Abstract

Purpose

To assess whether there is an association between the apparent diffusion coefficient (ADC) value and the pathological characteristics of prostate cancer.

Methods

The study cohort consisted of 29 consecutive patients with prostate cancer treated with radical prostatectomy. All patients underwent diffusion-weighted MRI before the prostate biopsy. In 42 tumor foci, the associations of the ADC values with the clinicopathological characteristics and Ki-67 labeling index (LI) were analyzed.

Results

High-grade cancers (Gleason score [GS] ≥ 4 + 3), larger cancers (maximum diameter (MD) ≥ 16 mm), and highly proliferating cancers (Ki-67 LI ≥ 4.43 %) had significantly lower ADC values, respectively (P < .001, P = .008, and P = .044, respectively). There was no significant difference in ADC value according to age, prostate-specific antigen, presence of extra-prostatic extension, and intra-tumoral stroma proportion. Multivariate analysis showed that GS, Ki-67 LI, and MD had independent and significant correlations with ADC value (P < .001, P = .006, and P = .002, respectively). Low ADC tumors (<0.52 × 10−3 mm2/s) are likely to be high-grade cancer foci compared with high ADC tumors (relative risk: 65.2). The sensitivity and specificity of the ADC value to predict high-grade cancer foci are 81.8 and 93.5 %, respectively.

Conclusions

A low ADC value reflects the morphological and biological features of prostate cancer. Analyzing the ADC value may make it possible to more precisely predict the cancer aggressiveness of each focus before treatment.

Keywords

Diffusion magnetic resonance imaging Prostatic neoplasms Biological markers Ki-67 Antigen