TY - JOUR
T1 - Prostate cancer
T2 - Utility of whole-lesion apparent diffusion coefficient metrics for prediction of biochemical recurrence after radical prostatectomy
AU - Rosenkrantz, Andrew B.
AU - Ream, Justin M.
AU - Nolan, Paul
AU - Rusinek, Henry
AU - Deng, Fang Ming
AU - Taneja, Samir S.
N1 - Publisher Copyright:
© American Roentgen Ray Society.
PY - 2015/12
Y1 - 2015/12
N2 - OBJECTIVE. The purpose of this study was to investigate the additional value of wholelesion histogram apparent diffusion coefficient (ADC) metrics, when combined with standard pathologic features, in prediction of biochemical recurrence (BCR) after radical prostatectomy for prostate cancer. MATERIALS AND METHODS. The study included 193 patients (mean age, 61 ± 7 years) who underwent 3-T MRI with DWI (b values, 50 and 1000 s/mm2) before prostatectomy. Histogram metrics were derived from 3D volumes of interest encompassing the entire lesion on ADC maps. Pathologic features from radical prostatectomy and subsequent BCR were recorded for each patient. The Fisher exact test and Mann-Whitney test were used to compare ADC-based metrics and pathologic features between patients with and patients without BCR. Stepwise logistic regression analysis was used to construct multivariable models for prediction of BCR, which were assessed by ROC analysis. RESULTS. BCR occurred in 16.6% (32/193) of patients. Variables significantly associated with BCR included primary Gleason grade, Gleason score, extraprostatic extension, seminal vesicle invasion, positive surgical margin, preoperative prostate-specific antigen level, MRI tumor volume, mean whole-lesion ADC, entropy ADC, and mean ADC of the bottom 10th, 10-25th, and 25-50th percentiles (p ? 0.019). Significant independent predictors of BCR at multivariable analysis were primary Gleason grade, extraprostatic extension, mean of the bottom 10th percentile ADC, and entropy ADC (p = 0.002-0.037). The AUC of this multivariable model was 0.94 for prediction of BCR; the AUC of pathologic features alone was 0.89 (p = 0.001). CONCLUSION. A model integrating whole-lesion ADC metrics had significantly higher performance for prediction of BCR than did standard pathologic features alone and may help guide postoperative prognostic assessments and decisions regarding adjuvant therapy.
AB - OBJECTIVE. The purpose of this study was to investigate the additional value of wholelesion histogram apparent diffusion coefficient (ADC) metrics, when combined with standard pathologic features, in prediction of biochemical recurrence (BCR) after radical prostatectomy for prostate cancer. MATERIALS AND METHODS. The study included 193 patients (mean age, 61 ± 7 years) who underwent 3-T MRI with DWI (b values, 50 and 1000 s/mm2) before prostatectomy. Histogram metrics were derived from 3D volumes of interest encompassing the entire lesion on ADC maps. Pathologic features from radical prostatectomy and subsequent BCR were recorded for each patient. The Fisher exact test and Mann-Whitney test were used to compare ADC-based metrics and pathologic features between patients with and patients without BCR. Stepwise logistic regression analysis was used to construct multivariable models for prediction of BCR, which were assessed by ROC analysis. RESULTS. BCR occurred in 16.6% (32/193) of patients. Variables significantly associated with BCR included primary Gleason grade, Gleason score, extraprostatic extension, seminal vesicle invasion, positive surgical margin, preoperative prostate-specific antigen level, MRI tumor volume, mean whole-lesion ADC, entropy ADC, and mean ADC of the bottom 10th, 10-25th, and 25-50th percentiles (p ? 0.019). Significant independent predictors of BCR at multivariable analysis were primary Gleason grade, extraprostatic extension, mean of the bottom 10th percentile ADC, and entropy ADC (p = 0.002-0.037). The AUC of this multivariable model was 0.94 for prediction of BCR; the AUC of pathologic features alone was 0.89 (p = 0.001). CONCLUSION. A model integrating whole-lesion ADC metrics had significantly higher performance for prediction of BCR than did standard pathologic features alone and may help guide postoperative prognostic assessments and decisions regarding adjuvant therapy.
KW - Apparent diffusion coefficient
KW - DWI
KW - MRI
KW - Prostate cancer
KW - Radical prostatectomy
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U2 - 10.2214/AJR.15.14482
DO - 10.2214/AJR.15.14482
M3 - Article
C2 - 26587927
AN - SCOPUS:84948755957
SN - 0361-803X
VL - 205
SP - 1208
EP - 1214
JO - The American journal of roentgenology and radium therapy
JF - The American journal of roentgenology and radium therapy
IS - 6
ER -