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Apparent Diffusion Coefficient Values of the Benign Central Zone of the Prostate: Comparison With Low- and High-Grade Prostate Cancer.

Publication ,  Journal Article
Gupta, RT; Kauffman, CR; Garcia-Reyes, K; Palmeri, ML; Madden, JF; Polascik, TJ; Rosenkrantz, AB
Published in: AJR Am J Roentgenol
August 2015

OBJECTIVE: The apparent diffusion coefficient (ADC) values for benign central zone (CZ) of the prostate were compared with ADC values of benign peripheral zone (PZ), benign transition zone (TZ), and prostate cancer, using histopathologic findings from radical prostatectomy as the reference standard. MATERIALS AND METHODS: The study included 27 patients with prostate cancer (mean [± SD] age, 60.0 ± 7.6 years) who had 3-T endorectal coil MRI of the prostate performed before undergoing prostatectomy with whole-mount histopathologic assessment. Mean ADC values were recorded from the ROI within the index tumor and within benign CZ, PZ, and TZ, with the use of histopathologic findings as the reference standard. ADC values of the groups were compared using paired t tests and ROC curve analysis. RESULTS: The ADC of benign CZ in the right (1138 ± 123 × 10(-6) mm(2)/s) and left (1166 ± 141 × 10(-6) mm(2)/s) lobes was not significantly different (p = 0.217). However, the ADC of benign CZ (1154 ± 129 × 10(-6) mm(2)/s) was significantly lower (p < 0.001) than the ADCs of benign PZ (1579 ± 197 × 10(-6) mm(2)/s) and benign TZ (1429 ± 180 × 10(-6) mm(2)/s). Although the ADC of index tumors (1042 ± 134 × 10(-6) mm(2)/s) was significantly lower (p = 0.002) than the ADC of benign CZ there was no significant difference (p = 0.225) between benign CZ and tumors with a Gleason score of 6 (1119 ± 87 × 10(-6) mm(2)/s). In 22.2% of patients (6/27), including five patients who had tumors with a Gleason score greater than 6, the ADC was lower in benign CZ than in the index tumor. The AUC of ADC for the differentiation of benign CZ from index tumors was 72.4% (sensitivity, 70.4%; specificity, 51.9%), and the AUC of ADC for differentiation from tumors with a Gleason score greater than 6 was 76.7% (sensitivity, 75.0%; specificity, 65.0%). CONCLUSION: The ADC of benign CZ is lower than the ADC of other zones of the prostate and overlaps with the ADC of prostate cancer tissue, including high-grade tumors. Awareness of this potential diagnostic pitfall is important to avoid misinterpreting the normal CZ as suspicious for tumor.

Duke Scholars

Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

August 2015

Volume

205

Issue

2

Start / End Page

331 / 336

Location

United States

Related Subject Headings

  • Prostatic Neoplasms
  • Prostatectomy
  • Prospective Studies
  • Nuclear Medicine & Medical Imaging
  • Neoplasm Grading
  • Middle Aged
  • Male
  • Image Interpretation, Computer-Assisted
  • Humans
  • Diffusion Magnetic Resonance Imaging
 

Citation

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MLA
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Gupta, R. T., Kauffman, C. R., Garcia-Reyes, K., Palmeri, M. L., Madden, J. F., Polascik, T. J., & Rosenkrantz, A. B. (2015). Apparent Diffusion Coefficient Values of the Benign Central Zone of the Prostate: Comparison With Low- and High-Grade Prostate Cancer. AJR Am J Roentgenol, 205(2), 331–336. https://doi.org/10.2214/AJR.14.14221
Gupta, Rajan T., Christopher R. Kauffman, Kirema Garcia-Reyes, Mark L. Palmeri, John F. Madden, Thomas J. Polascik, and Andrew B. Rosenkrantz. “Apparent Diffusion Coefficient Values of the Benign Central Zone of the Prostate: Comparison With Low- and High-Grade Prostate Cancer.AJR Am J Roentgenol 205, no. 2 (August 2015): 331–36. https://doi.org/10.2214/AJR.14.14221.
Gupta RT, Kauffman CR, Garcia-Reyes K, Palmeri ML, Madden JF, Polascik TJ, et al. Apparent Diffusion Coefficient Values of the Benign Central Zone of the Prostate: Comparison With Low- and High-Grade Prostate Cancer. AJR Am J Roentgenol. 2015 Aug;205(2):331–6.
Gupta, Rajan T., et al. “Apparent Diffusion Coefficient Values of the Benign Central Zone of the Prostate: Comparison With Low- and High-Grade Prostate Cancer.AJR Am J Roentgenol, vol. 205, no. 2, Aug. 2015, pp. 331–36. Pubmed, doi:10.2214/AJR.14.14221.
Gupta RT, Kauffman CR, Garcia-Reyes K, Palmeri ML, Madden JF, Polascik TJ, Rosenkrantz AB. Apparent Diffusion Coefficient Values of the Benign Central Zone of the Prostate: Comparison With Low- and High-Grade Prostate Cancer. AJR Am J Roentgenol. 2015 Aug;205(2):331–336.

Published In

AJR Am J Roentgenol

DOI

EISSN

1546-3141

Publication Date

August 2015

Volume

205

Issue

2

Start / End Page

331 / 336

Location

United States

Related Subject Headings

  • Prostatic Neoplasms
  • Prostatectomy
  • Prospective Studies
  • Nuclear Medicine & Medical Imaging
  • Neoplasm Grading
  • Middle Aged
  • Male
  • Image Interpretation, Computer-Assisted
  • Humans
  • Diffusion Magnetic Resonance Imaging