Predicting biochemical recurrence in patients with high-risk prostate cancer using the apparent diffusion coefficient of magnetic resonance imaging

• Published in: Investigative and clinical urology Vol. 58; no. 1; pp. 12 - 19
• Main Authors: Yoon, Min Young, Park, Juhyun, Cho, Jeong Yeon, Jeong, Chang Wook, Ku, Ja Hyeon, Kim, Hyeon Hoe, Kwak, Cheol
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Urological Association 2017; Korean Urological Association; 대한비뇨의학회
• Subjects: Aged; Area Under Curve; Diffusion Magnetic Resonance Imaging; Disease-Free Survival; Humans; Lymphatic Metastasis; Magnetic resonance imaging; Prognosis; Prostate neoplasms; Recurrence; Male; Middle Aged; Neoplasm Recurrence, Local - blood; Original; Predictive Value of Tests; Prognosis; Prostate-Specific Antigen - blood; Prostatectomy; Prostatic Neoplasms - blood; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - pathology; Prostatic Neoplasms - surgery; Risk Factors; ROC Curve; 비뇨기과학; Prostate neoplasms; Recurrence; Prognosis; Magnetic resonance imaging
• ISSN: 2466-0493; 2466-054X; 2466-054X
• DOI: 10.4111/icu.2017.58.1.12

We aimed to investigate whether the apparent diffusion coefficient (ADC) value in diffusion-weighted magnetic resonance imaging predicts the prognoses of patients with high-risk prostate cancer. A total of 157 patients with high-risk prostate cancer (based on D'Amico's criteria) were included in the analysis. Patients underwent preoperative 3.0 Tesla magnetic resonance imaging within 2 months before radical prostatectomy. Those who received neoadjuvant hormone therapy (33 persons) or radiation therapy (18 persons) were excluded. The ADC of the tumor calculated from 2 b-values (0 and 1,000 s/mm ) was measured. Areas under receiver operating characteristics curves were calculated to maximize the accuracy of the ADC value. Based on the obtained cutoff value, the patients were stratified into 2 groups: Group A consisted of patients with ADC values <746×10 mm /s and group B comprised those with ADC values ≥746×10 mm /s. Group A showed higher rate of lymph positive and biochemical recurrence (BCR) rates than group B. Kaplan-Meier analysis showed that the BCR-free survival rate of group A was much lower than that of group B (p<0.001). On Cox proportional regression analyses, ADC group A (hazard ratio [HR], 3.238, p=0.002) and pathologic lymph node positive (HR, 2.242; p=0.009) were independent predictors of BCR. In patients with high-risk prostate cancer, ADC value is significantly associated with BCR-free survival. Therefore, the ADC value is a useful tool for predicting the prognoses of these high-risk patients.