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The role of whole-lesion apparent diffusion coefficient analysis for predicting outcomes of prostate cancer patients on active surveillance

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Abstract

Purpose

To explore the role of whole-lesion apparent diffusion coefficient (ADC) analysis for predicting outcomes in prostate cancer patients on active surveillance.

Methods

This study included 72 prostate cancer patients who underwent MRI–ultrasound fusion-targeted biopsy at the initiation of active surveillance, had a visible MRI lesion in the region of tumor on biopsy, and underwent 3T baseline and follow-up MRI examinations separated by at least one year. Thirty of the patients also underwent an additional MRI–ultrasound fusion-targeted biopsy after the follow-up MRI. Whole-lesion ADC metrics and lesion volumes were computed from 3D whole-lesion volumes-of-interest placed on lesions on the baseline and follow-up ADC maps. The percent change in lesion volume on the ADC map between the serial examinations was computed. Statistical analysis included unpaired t tests, ROC analysis, and Fisher’s exact test.

Results

Baseline mean ADC, ADC0–10th-percentile, ADC10–25th-percentile, and ADC25–50th-percentile were all significantly lower in lesions exhibiting ≥50% growth on the ADC map compared with remaining lesions (all P ≤ 0.007), with strongest difference between lesions with and without ≥50% growth observed for ADC0–10th-percentile (585 ± 308 vs. 911 ± 336; P = 0.001). ADC0–10th-percentile achieved highest performance for predicting ≥50% growth (AUC = 0.754). Mean percent change in tumor volume on the ADC map was 62.3% ± 26.9% in patients with GS ≥ 3 + 4 on follow-up biopsy compared with 3.6% ± 64.6% in remaining patients (P = 0.050).

Conclusion

Our preliminary results suggest a role for 3D whole-lesion ADC analysis in prostate cancer active surveillance.

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Authors and Affiliations

  1. Department of Radiology, NYU Langone Medical Center, 550 First Ave, New York, NY, 10016, USA

    Tsutomu Tamada & Andrew B. Rosenkrantz

  2. Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, 701-0192, Japan

    Tsutomu Tamada

  3. Division of Urologic Oncology, Department of Urology, NYU Langone Medical Center, 550 First Ave, New York, NY, 10016, USA

    Hasan Dani & Samir S. Taneja

Authors
  1. Tsutomu Tamada
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  2. Hasan Dani
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  3. Samir S. Taneja
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  4. Andrew B. Rosenkrantz
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Corresponding author

Correspondence to Tsutomu Tamada.

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Funding

This study was funded by Joseph and Diane Steinberg Charitable Trust.

Conflicts of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Informed consent

The local institutional review board provided a waiver of the requirement for written informed consent.

Disclosures

Rosenkrantz (royalties from Thieme Medical Publishers). Taneja (consultant for Hitachi-Aloka; nonfinancial support from Biobot). Remaining authors (no disclosures).

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Tamada, T., Dani, H., Taneja, S.S. et al. The role of whole-lesion apparent diffusion coefficient analysis for predicting outcomes of prostate cancer patients on active surveillance. Abdom Radiol 42, 2340–2345 (2017). https://doi.org/10.1007/s00261-017-1135-2

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