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Diagnostic value of ADC in patients with prostate cancer: influence of the choice of b values

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Abstract

Objectives

To evaluate the influence of the choice of b values on the diagnostic value of the apparent diffusion coefficient (ADC) for detection and grading of prostate cancer (PCa).

Methods

Forty-one patients with biopsy-proven PCa underwent endorectal 3-T MRI before prostatectomy. Different combinations of b values (0–800 s/mm2) were used to calculate four representative ADC maps. Mean ADCs of tumours and non-malignant tissue were determined. Tumour appearance on different ADC maps was rated by three radiologists as good, fair or poor by assigning a visual score (VS) of 2, 1 or 0, respectively. Differences in the ADC values with the choice of b values were analysed using one-way ANOVA.

Results

Choice of b values had a highly (P < 0.001) significant influence on the absolute ADC in each tissue. Maps using b = [50, 800] and [0, 800] were rated best (VS = 1.6 ± 0.3) and second best (1.1 ± 0.3, P < 0.001), respectively. For low-grade carcinomas (Gleason score ≤ 6, 13/41 patients), only the former choice received scores better than fair (VS = 1.4 ± 0.3). Mean tumour ADCs showed significant negative correlation (Spearman’s ρ −0.38 to −0.46, P < 0.05) with Gleason score.

Conclusions

Absolute ADC values strongly depend on the choice of b values and therefore should be used with caution for diagnostic purposes. A minimum b value greater than zero is recommended for ADC calculation to improve the visual assessment of PCa in ADC maps.

Key Points

• Absolute ADC values are highly dependent on the choice of b values.

• Absolute ADC thresholds should be used carefully to predict tumour aggressiveness.

• Subjective ratings of ADC maps involving b = 0 s/mm 2 are poor to fair.

• Minimum b value greater than 0 s/mm 2 is recommended for ADC calculation.

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Abbreviations

CG:

central gland

CSI:

chemical shift imaging

GS:

Gleason score

PCa:

prostate cancer

PZ:

peripheral zone

VS:

visual score

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Acknowledgement

Grant support from the German Federal Ministry of Education and Research under BMBF 13N10360 is gratefully acknowledged.

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Authors and Affiliations

  1. Department of Diagnostic and Interventional Radiology, Leipzig University Hospital, Liebigstrasse 20, 04103, Leipzig, Germany

    Gregor Thörmer, Josephin Otto, Martin Reiss-Zimmermann, Matthias Seiwerts, Michael Moche, Nikita Garnov, Thomas Kahn & Harald Busse

  2. Department of Urology, Leipzig University Hospital, Leipzig, Germany

    Toni Franz, Minh Do & Jens-Uwe Stolzenburg

  3. Institute of Pathology, University of Leipzig, Leipzig, Germany

    Lars-Christian Horn

Authors
  1. Gregor Thörmer
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  2. Josephin Otto
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Correspondence to Harald Busse.

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Thörmer, G., Otto, J., Reiss-Zimmermann, M. et al. Diagnostic value of ADC in patients with prostate cancer: influence of the choice of b values. Eur Radiol 22, 1820–1828 (2012). https://doi.org/10.1007/s00330-012-2432-3

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  • DOI: https://doi.org/10.1007/s00330-012-2432-3

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