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Abstract
To investigate the value of the 1.5T magnetic resonance imaging (MRI) apparent diffusion coefficient (ADC) and the prostate imaging reporting and data system (PI-RADS) score in prostate cancer (PCa) screening.Forty PCa patients diagnosed by pathology from December 2014 to September 2018 were recruited as the PCa group; 60 patients with benign prostatic hyperplasia (BPH) were recruited as the benign group. Patients from both groups underwent 1.5T MRI scanning. The prostate ADC values, exponential apparent diffusion coefficient (eADC) values, and PI-RADS scores of patients from the 2 groups were compared. The different methods for PCa diagnosis were compared.The ADC values of patients in the PCa group were significantly lower than those in the benign group, whereas the eADC values of patients were significantly higher than those in the benign group, with statistically significant differences (P < .05). The differences in the PI-RADS scores of patients from the 2 groups were statistically significant (P < .05). Receiver Operating Characteristic (ROC) curve results showed that the ADC value combined with the PI-RADS score was superior to the ADC value or the PI-RADS score alone in sensitivity, specificity, and Youden index for PCa diagnosis. By comparing the area under the curve (AUC) of each ROC curve from the different diagnostic methods, the combination of ADC value and PI-RADS score showed the largest area.The ADC value from 1.5T MRI combined with the PI-RADS score could be used as the standard for PCa screening, which would effectively improve screening for PCa and be valuable for clinical applications.
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Affiliation(s)
| | - Lianqiang Shan
- Department of Radiology, The Second Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui, China
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Westphalen AC, Fazel F, Nguyen H, Cabarrus M, Hanley-Knutson K, Shinohara K, Carroll PR. Detection of clinically signifi cant prostate cancer with PIRADS v2 scores, PSA density, and ADC values in regions with and without mpMRI visible lesions. Int Braz J Urol 2019; 45:713-723. [PMID: 31136112 PMCID: PMC6837611 DOI: 10.1590/s1677-5538.ibju.2018.0768] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 03/06/2019] [Indexed: 01/18/2023] Open
Abstract
Purpose To determine if PSAD, PSADtz, and ADC values improve the accuracy of PI-RADS v2 and identify men whose concurrent systematic biopsy detects clinically significant cancer on areas without mpMRI visible lesions. Materials and methods Single reference-center, cross-sectional, retrospective study of consecutive men with suspected or known low to intermediate-risk prostate cancer who underwent 3T mpMRI and TRUS-MRI fusion biopsy from 07/15/2014 to 02/17/2018. Cluster-corrected logistic regression analyses were utilized to predict clinically significant prostate cancer (Gleason score ≥3+4) at targeted mpMRI lesions and on systematic biopsy. Results 538 men (median age=66 years, median PSA=7.0ng/mL) with 780mpMRI lesions were included. Clinically significant disease was diagnosed in 371 men. PI-RADS v2 scores of 3, 4, and 5 were clinically significant cancer in 8.0% (16/201), 22.8% (90/395), and 59.2% (109/184). ADC values, PSAD, and PI-RADS v2 scores were independent predictors of clinically significant cancer in targeted lesions (OR 2.25-8.78; P values <0.05; AUROC 0.84, 95% CI 0.81-0.87). Increases in PSAD were also associated with upgrade on systematic biopsy (OR 2.39-2.48; P values <0.05; AUROC 0.69, 95% CI 0.64-0.73). Conclusions ADC values and PSAD improve characterization of PI-RADS v2 score 4 or 5 lesions. Upgraded on systematic biopsy is slightly more likely with PSAD ≥0.15 and multiple small PI-RADS v2 score 3 or 4 lesions.
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Affiliation(s)
- Antonio C Westphalen
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA.,Department of Urology, University of California, San Francisco, CA, USA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Farhad Fazel
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Hao Nguyen
- Department of Urology, University of California, San Francisco, CA, USA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Miguel Cabarrus
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Katryana Hanley-Knutson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Katsuto Shinohara
- Department of Urology, University of California, San Francisco, CA, USA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Peter R Carroll
- Department of Urology, University of California, San Francisco, CA, USA.,Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
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