Prostate Cancer Aggressiveness: Assessment with Whole-Lesion Histogram Analysis of the Apparent Diffusion Coefficient

医学 有效扩散系数 百分位 前列腺癌 前列腺切除术 接收机工作特性 前列腺 磁共振成像 核医学 放射科 磁共振弥散成像 斯皮尔曼秩相关系数 癌症 内科学 数学 统计
作者
Olivio F. Donati,Yousef Mazaheri,Asim Afaq,Hebert Alberto Vargas,Junting Zheng,Chaya S. Moskowitz,Hedvig Hricak,Oğuz Akın
出处
期刊:Radiology [Radiological Society of North America]
卷期号:271 (1): 143-152 被引量:266
标识
DOI:10.1148/radiol.13130973
摘要

Purpose To evaluate the relationship between prostate cancer aggressiveness and histogram-derived apparent diffusion coefficient (ADC) parameters obtained from whole-lesion assessment of diffusion-weighted magnetic resonance (MR) imaging of the prostate and to determine which ADC metric may help best differentiate low-grade from intermediate- or high-grade prostate cancer lesions. Materials and Methods The institutional review board approved this retrospective HIPAA-compliant study of 131 men (median age, 60 years) who underwent diffusion-weighted MR imaging before prostatectomy for prostate cancer. Clinically significant tumors (tumor volume > 0.5 mL) were identified at whole-mount step-section histopathologic examination, and Gleason scores of the tumors were recorded. A volume of interest was drawn around each significant tumor on ADC maps. The mean, median, and 10th and 25th percentile ADCs were determined from the whole-lesion histogram and correlated with the Gleason score by using the Spearman correlation coefficient (ρ). The ability of each parameter to help differentiate tumors with a Gleason score of 6 from those with a Gleason score of at least 7 was assessed by using the area under the receiver operating characteristic curve (Az). Results In total, 116 clinically significant lesions (89 in the peripheral zone, 27 in the transition zone) were identified in 85 of the 131 patients (65%). Forty-six patients did not have a clinically significant lesion. For mean ADC, median ADC, 10th percentile ADC, and 25th percentile ADC, the Spearman ρ values for correlation with Gleason score were −0.31, −0.30, −0.36, and −0.35, respectively, whereas the Az values for differentiating lesions with a Gleason score of 6 from those with a Gleason score of at least 7 were 0.704, 0.692, 0.758, and 0.723, respectively. The Az of 10th percentile ADC was significantly higher than that of the mean ADC for all lesions and peripheral zone lesions (P = .0001). Conclusion When whole-lesion histograms were used to derive ADC parameters, 10th percentile ADC correlated with Gleason score better than did other ADC parameters, suggesting that 10th percentile ADC may prove to be optimal for differentiating low-grade from intermediate- or high-grade prostate cancer with diffusion-weighted MR imaging. © RSNA, 2013
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