The role of 3-tesla diffusion-weighted magnetic resonance imaging in selecting prostate cancer patients for active surveillance
Differentiating significant cancer from insignificant cancer is a major challenge in active surveillance (AS) for prostate cancer. We evaluated whether the apparent diffusion coefficient (ADC) grade from 3-T diffusion-weighted magnetic resonance imaging (DW-MRI) is useful to exclude men with unfavor...
| Main Authors: | , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2014-12-01
|
| Series: | Prostate International |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2287888215300660 |
| _version_ | 1797763086999879680 |
|---|---|
| author | Chang Wook Jeong Yong Hyun Park |
| author_facet | Chang Wook Jeong Yong Hyun Park |
| author_sort | Chang Wook Jeong |
| collection | DOAJ |
| description | Differentiating significant cancer from insignificant cancer is a major challenge in active surveillance (AS) for prostate cancer. We evaluated whether the apparent diffusion coefficient (ADC) grade from 3-T diffusion-weighted magnetic resonance imaging (DW-MRI) is useful to exclude men with unfavorable pathological features from men meeting current AS eligibility criteria.
Methods: Among patients who underwent radical prostatectomy, 117 potential AS candidates defined according to 2013 European Association of Urology guidelines who had undergone preoperative 3-T DW-MRI were included. A blinded uro-radiologist graded the level of suspicion from the ADC map using the Likert scale from 1 to 5. The rate of unfavorable pathological features was evaluated according to ADC grade. Unfavorable pathological features were defined as non-organ-confined disease or pathological Gleason score ≥ 7 (4+3). The associations between unfavorable pathological features and clinical variables including ADC grade (>3 vs. ≤3) were evaluated using logistic regression analysis.
Results: The rates of unfavorable pathological features were 0.0% (0/14), 2.9% (1/34), 5.4% (2/37), 25.0% (6/24), and 37.5% (3/8) from grades 1 to 5 (P =0.002). The predictive accuracy was as high as 0.804. The rates were significantly different between low (≤3, 3.5%) and high (>3, 28.1%, P<0.001) grades. The sensitivity, specificity, and positive and negative predictive values were 75.0%, 78.1%, 28.1%, and 96.5%. ADC grade (odds ratio [OR], 10.696; 95% confidence interval [CI], 2.675-42.773) was significantly associated with unfavorable pathological features, even after adjusting for other variables (OR, 11.274; 95% CI, 2.622-48.471).
Conclusions: ADC grade from 3-T DW-MRI is useful to predict men with unfavorable pathologic features from AS candidates. |
| first_indexed | 2024-03-12T19:37:34Z |
| format | Article |
| id | doaj.art-7f653b05ebe7485b8d9fe990d2565ddf |
| institution | Directory Open Access Journal |
| issn | 2287-8882 |
| language | English |
| last_indexed | 2024-03-12T19:37:34Z |
| publishDate | 2014-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Prostate International |
| spelling | doaj.art-7f653b05ebe7485b8d9fe990d2565ddf2023-08-02T04:06:28ZengElsevierProstate International2287-88822014-12-012416917510.12954/PI.14057The role of 3-tesla diffusion-weighted magnetic resonance imaging in selecting prostate cancer patients for active surveillanceChang Wook JeongYong Hyun ParkDifferentiating significant cancer from insignificant cancer is a major challenge in active surveillance (AS) for prostate cancer. We evaluated whether the apparent diffusion coefficient (ADC) grade from 3-T diffusion-weighted magnetic resonance imaging (DW-MRI) is useful to exclude men with unfavorable pathological features from men meeting current AS eligibility criteria. Methods: Among patients who underwent radical prostatectomy, 117 potential AS candidates defined according to 2013 European Association of Urology guidelines who had undergone preoperative 3-T DW-MRI were included. A blinded uro-radiologist graded the level of suspicion from the ADC map using the Likert scale from 1 to 5. The rate of unfavorable pathological features was evaluated according to ADC grade. Unfavorable pathological features were defined as non-organ-confined disease or pathological Gleason score ≥ 7 (4+3). The associations between unfavorable pathological features and clinical variables including ADC grade (>3 vs. ≤3) were evaluated using logistic regression analysis. Results: The rates of unfavorable pathological features were 0.0% (0/14), 2.9% (1/34), 5.4% (2/37), 25.0% (6/24), and 37.5% (3/8) from grades 1 to 5 (P =0.002). The predictive accuracy was as high as 0.804. The rates were significantly different between low (≤3, 3.5%) and high (>3, 28.1%, P<0.001) grades. The sensitivity, specificity, and positive and negative predictive values were 75.0%, 78.1%, 28.1%, and 96.5%. ADC grade (odds ratio [OR], 10.696; 95% confidence interval [CI], 2.675-42.773) was significantly associated with unfavorable pathological features, even after adjusting for other variables (OR, 11.274; 95% CI, 2.622-48.471). Conclusions: ADC grade from 3-T DW-MRI is useful to predict men with unfavorable pathologic features from AS candidates.http://www.sciencedirect.com/science/article/pii/S2287888215300660Prostatic neoplasmsWatchful waitingPathologyMagnetic resonance imaging |
| spellingShingle | Chang Wook Jeong Yong Hyun Park The role of 3-tesla diffusion-weighted magnetic resonance imaging in selecting prostate cancer patients for active surveillance Prostate International Prostatic neoplasms Watchful waiting Pathology Magnetic resonance imaging |
| title | The role of 3-tesla diffusion-weighted magnetic resonance imaging in selecting prostate cancer patients for active surveillance |
| title_full | The role of 3-tesla diffusion-weighted magnetic resonance imaging in selecting prostate cancer patients for active surveillance |
| title_fullStr | The role of 3-tesla diffusion-weighted magnetic resonance imaging in selecting prostate cancer patients for active surveillance |
| title_full_unstemmed | The role of 3-tesla diffusion-weighted magnetic resonance imaging in selecting prostate cancer patients for active surveillance |
| title_short | The role of 3-tesla diffusion-weighted magnetic resonance imaging in selecting prostate cancer patients for active surveillance |
| title_sort | role of 3 tesla diffusion weighted magnetic resonance imaging in selecting prostate cancer patients for active surveillance |
| topic | Prostatic neoplasms Watchful waiting Pathology Magnetic resonance imaging |
| url | http://www.sciencedirect.com/science/article/pii/S2287888215300660 |
| work_keys_str_mv | AT changwookjeong theroleof3tesladiffusionweightedmagneticresonanceimaginginselectingprostatecancerpatientsforactivesurveillance AT yonghyunpark theroleof3tesladiffusionweightedmagneticresonanceimaginginselectingprostatecancerpatientsforactivesurveillance AT changwookjeong roleof3tesladiffusionweightedmagneticresonanceimaginginselectingprostatecancerpatientsforactivesurveillance AT yonghyunpark roleof3tesladiffusionweightedmagneticresonanceimaginginselectingprostatecancerpatientsforactivesurveillance |