The role of whole-lesion apparent diffusion coefficient analysis for predicting outcomes of prostate cancer patients on active surveillance

Tsutomu Tamada, Hasan Dani, Samir S. Taneja, Andrew B. Rosenkrantz

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: To explore the role of whole-lesion apparent diffusion coefficient (ADC) analysis for predicting outcomes in prostate cancer patients on active surveillance. Methods: This study included 72 prostate cancer patients who underwent MRI–ultrasound fusion-targeted biopsy at the initiation of active surveillance, had a visible MRI lesion in the region of tumor on biopsy, and underwent 3T baseline and follow-up MRI examinations separated by at least one year. Thirty of the patients also underwent an additional MRI–ultrasound fusion-targeted biopsy after the follow-up MRI. Whole-lesion ADC metrics and lesion volumes were computed from 3D whole-lesion volumes-of-interest placed on lesions on the baseline and follow-up ADC maps. The percent change in lesion volume on the ADC map between the serial examinations was computed. Statistical analysis included unpaired t tests, ROC analysis, and Fisher’s exact test. Results: Baseline mean ADC, ADC0–10th-percentile, ADC10–25th-percentile, and ADC25–50th-percentile were all significantly lower in lesions exhibiting ≥50% growth on the ADC map compared with remaining lesions (all P ≤ 0.007), with strongest difference between lesions with and without ≥50% growth observed for ADC0–10th-percentile (585 ± 308 vs. 911 ± 336; P = 0.001). ADC0–10th-percentile achieved highest performance for predicting ≥50% growth (AUC = 0.754). Mean percent change in tumor volume on the ADC map was 62.3% ± 26.9% in patients with GS ≥ 3 + 4 on follow-up biopsy compared with 3.6% ± 64.6% in remaining patients (P = 0.050). Conclusion: Our preliminary results suggest a role for 3D whole-lesion ADC analysis in prostate cancer active surveillance.

Original languageEnglish (US)
Pages (from-to)2340-2345
Number of pages6
JournalAbdominal Radiology
Volume42
Issue number9
DOIs
StatePublished - Sep 1 2017

Keywords

  • Active surveillance
  • Apparent diffusion coefficient
  • DWI
  • MRI
  • Prostate cancer

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

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