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Effects of the addition of quantitative apparent diffusion coefficient data on the diagnostic performance of the PI-RADS v2 scoring system to detect clinically significant prostate cancer

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Abstract

Purpose

To evaluate the impact of the addition of quantitative apparent diffusion coefficient (ADC) data into the diagnostic performance of the Prostate Imaging Reporting and Data System version 2 (PI-RADSv2) scoring system to predict clinically significant prostate cancer (CSPCa).

Methods

We retrospectively included 91 consecutive patients who underwent prostate multiparametric magnetic resonance imaging (mp-MRI) and histopathological evaluation. Mp-MRI images were reported by the PI-RADSv2 scoring system and patients were divided into groups considering the likelihood of CSPCa. ADC value and ratio were obtained. Findings were correlated with histopathological data.

Results

CSPCa was found in 41.8% of cases (n = 38). PI-RADSv2 score 3–5 yielded a sensitivity of 97.4% (95% confidence intervals 86.5–99.5), a specificity of 50.9% (37.9–63.9), and AUC of 0.74 (0.67–0.81) to predict CSPCa. ADC value < 750 µm2/s and an ADC ratio < 0.62 were the most accurate thresholds for differentiation of CSPCa, with AUC of 0.81 and 0.76, respectively. Combined PI-RADSv2 score 3–5 and ADC value < 750 µm2/s yielded a specificity of 84.9 (72.9–92.2), sensitivity of 70.3 (54.2–82.5), and AUC of 0.77 (0.68–0.86). Combined PI-RADSv2 score 3–5 and ADC ratio < 0.62 yielded a specificity of 86.5 (74.7–93.3), sensitivity of was 64.9 (48.8–78.2), and AUC of 0.75 (0.66–0.84).

Conclusion

Quantitative ADC data might not be beneficial to be used routinely in mp-MR imaging as criteria to detect clinically significant lesions due to the reduced sensitivity. Instead, when prostate lesions present a PI-RADSv2 score ≥ 3, additional quantitative ADC criteria can be helpful to increase the PI-RADS score specificity.

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Acknowledgements

This study was conducted in accordance with the amended Declaration of Helsinki and with the approval of the local Institutional Review Board.

Author information

Authors and Affiliations

  1. Department of Radiology, Pontificia Universidade Católica Do Rio Grande Do Sul, Av. Ipiranga, 6681, Porto Alegre, 90619900, Brazil

    Marcia Oliveira Moraes, Diego H. H. Roman, Josenel Copetti, Francisco de S. Santos, Alexandre Agra, Jorge A. P. Noronha, Gustavo Carvalhal, Eurico J. Dornelles Neto, Matheus Zanon & Bruno Hochhegger

  2. Medical Imaging Research Lab, LABIMED, Department of Radiology, Pavilhão Pereira Filho Hospital, Irmandade Santa Casa de Misericórdia de Porto Alegre, Av. Independência, 75, Porto Alegre, 90020-160, Brazil

    Matheus Zanon & Bruno Hochhegger

  3. Department of Diagnostic Methods, Federal University of Health Sciences of Porto Alegre, R. Sarmento Leite, 245, Porto Alegre, 90050170, Brazil

    Matheus Zanon, Matteo Baldisserotto & Bruno Hochhegger

Authors
  1. Marcia Oliveira Moraes
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  2. Diego H. H. Roman
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  3. Josenel Copetti
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  6. Jorge A. P. Noronha
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  8. Eurico J. Dornelles Neto
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  9. Matheus Zanon
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Contributions

MOM: Project development, Data collection and management, Data analysis, Manuscript writing/editing. DHHR: Project development, Data collection and management, Data analysis, Manuscript writing/editing. JC: Data collection and management, Data analysis. FSS: Data collection and management, Data analysis. AA: Data collection and management, Data analysis. JAPN: Data collection and management, Data analysis. GC: Data collection and management, Data analysis. EJDN: Data collection and management, Data analysis. MZ: Data management, Data analysis, Manuscript writing/editing. MB: Project development, Data collection and management, Data analysis, Manuscript writing/editing. BH: Project development, Data collection and management, Data analysis, Manuscript writing/editing.

Corresponding author

Correspondence to Matheus Zanon.

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Conflict of interest

None of the authors has any conflict of interest to express, including financial or personal relationships that could inappropriately influence his or her actions.

Ethical approval

This study has gained ethical approval from the local research review board (PUCRS/HSL Committee, Brazil, IRB00008131). All procedures performed in studies involving human participants were in accordance with the ethical standards of our institutional research committee and with the 1964 Helsinki declaration and its later amendments. Informed consent was obtained from all individual participants included in the study.

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Moraes, M.O., Roman, D.H.H., Copetti, J. et al. Effects of the addition of quantitative apparent diffusion coefficient data on the diagnostic performance of the PI-RADS v2 scoring system to detect clinically significant prostate cancer. World J Urol 38, 981–991 (2020). https://doi.org/10.1007/s00345-019-02827-2

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  • DOI: https://doi.org/10.1007/s00345-019-02827-2

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