Assessment of Apparent Diffusion Coefficient (ADC) Measurements in Diffusion-Weighted Magnetic Resonance Imaging (DW-MRI) to Distinguish Between Prostate Cancer, Prostatitis, and Normal Prostate

Syeda Mariam Zehra; Nazia  Dildar; Saima  Omar; Uzma  Nisar; Adil  Qayyum; Fareeha  Awan

doi:10.51253/pafmj.v76iSUPPL-8.12570

Authors

Syeda Mariam Zehra Department of Radiology, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Nazia Dildar Department of Radiology, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Saima Omar Department of Radiology, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Uzma Nisar Department of Radiology, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Adil Qayyum Department of Radiology, Combined Military Hospital, Rawalpindi/National University of Medical Sciences (NUMS) Pakistan
Fareeha Awan Department of Radiology, Combined Military Hospital, Gilgit/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v76iSUPPL-8.12570

Keywords:

Apparent Diffusion Coefficient (ADC), Diffusion Magnetic Resonance Imaging (MRI), Prostatic Neoplasms, Benign, Prostatic Neoplasms, Malignant

Abstract

Objective: To evaluate the diagnostic precision of ADC measurements in distinguishing between prostatitis, normal prostate tissue, and prostate cancer through Diffusion-Weighted Imaging (DWI).

Study Design: Comparative Cross-sectional Study

Place and Duration of Study: Radiology department of the CMH Rawalpindi, Pakistan, from Sep to Dec 2023.

Methodology: The study comprised 60 patients with elevated PSA levels of more than 4 ng/ml and a suspicion of prostate cancer. It was decided to use convenience sampling. In order to distinguish between benign prostate tissue, prostatitis, and malignancy, an MRI procedure was put into place. With an ADC cut-off value of 0.92 (x 10-3 mm2/sec), data was collected, entered, and analyzed, and sensitivity and specificity of each cut-off were associated. A one-way ANOVA test was used to compare the ADC values among the groups.

Results: The final analysis included the histopathologic examination of TRUS-guided biopsy for 55 patients. The sample's mean age was 59.93 ±8.76. The mean ADC values for normal tissue, prostatitis, and prostate cancer were 1.16 ±0.10x10-3 mm2/s, 1.50 ±0.07 x 10-3 mm2/s, and 0.85 + 0.10x 10-3 mm2, respectively. The difference was statistically significant (p<0.001).

Conclusion: The combination of DWI and ADC calculation offers more precise detection and characterisation of benign and malignant prostatic lesions. 0.92 (x 10-3 mm2/s) was the optimal threshold ADC value for achieving the maximum diagnostic precision.

Downloads

Download data is not yet available.

References

1. Yoo S, Gujrathi I, Haider MA, Khalvati F. Prostate cancer detection using deep convolutional neural networks. Sci rep 2019; 9(1): 19518.

https://doi.org/10.1038/s41598-019-55972-4

2. Descotes JL. Diagnosis of prostate cancer. Asian J Urol 2019; 6(2): 129-136.

https://doi.org/10.1016/j.ajur.2018.11.007

3. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2021; 71(3): 209-249.

https://doi.org/10.3322/caac.21660

4. Akhtar S, Hassan F, Ahmad S, El-Affendi MA, Khan MI. The prevalence of prostate cancer in Pakistan: A systematic review and meta-analysis. Heliyon 2023; 9(10): e20350.

https://doi.org/ 10.1016/j.heliyon.2023.e20350

5. Radovanović M, Zubelić A, Šantrić V, Milojević B, Bumbaširević U, Stanković B. Evaluating the clinical application of PAMD score in the assessment of TRUS-biopsy-positive outcomes in patients with PSA 4-10 ng/ml treated in Serbia. Med Istraž 2023; 56(1): 15-20.

https://doi.org/10.5937/medi55-41565

6. Obino M. Diagnostic accuracy of multi-parametric MRI in diagnosis of clinically significant prostate cancer [master's dissertation]. Nairobi (Kenya): Aga Khan University, East Africa; 2019. https://ecommons.aku.edu/cgi/viewcontent.cgi?article=3017&context=theses_dissertations

7. Ragheb SR, Bassiouny RH. Can mean ADC value and ADC ratio of benign prostate tissue to prostate cancer assist in the prediction of clinically significant prostate cancer within the PI-RADSv2 scoring system? Egypt J Radiol Nucl Med 2020; 51: 1-2.

https://doi.org/10.1186/s43055-020-00347-3

8. Raspe J, Harder FN, Rupp S, McTavish S, Peeters JM, Weiss K, et al. Retrospective Motion Artifact Reduction by Spatial Scaling of Liver Diffusion-Weighted Images. Tomography 2023; 9(5): 1839-1856.

https://doi.org/10.3390/tomography9050146

9. Soydan L, Demir AA, Torun M, Cikrikcioglu MA. Use of diffusion-weighted magnetic resonance imaging and apparent diffusion coefficient in gastric cancer staging. Curr Med Imaging 2020; 16(10): 1278-1289.

https://doi.org/10.2174/1573405616666200218124926

10. Lucarelli NM, Villanova I, Maggialetti N, Greco S, Tarantino F, Russo R, et al. Quantitative ADC: An Additional Tool in the Evaluation of Prostate Cancer?. J Pers Med 2023; 13(9): 1378.

https://doi.org/10.3390/jpm13091378

11. Hanif M, Zaidi P, Kamal S, Hameed A. Institution-based cancer incidence in a local population in Pakistan: nine year data analysis. Asian Pac J Cancer Prev 2009 Apr 1; 10(2) : 227-230.

12. Gibbons M, Starobinets O, Simko JP, Kurhanewicz J, Carroll PR, Noworolski SM. Identification of prostate cancer using multiparametric MR imaging characteristics of prostate tissues referenced to whole-mount histopathology. Magn Reson Imaging 2022; 85: 251-261.

https://doi.org/10.1016/j.mri.2021.10.008

13. Lemberskiy G, Chandarana H, Bruno M, Ginocchio LA, Huang C, Tong A, et al. Feasibility of accelerated prostate diffusion-weighted imaging on 0.55 T MRI enabled with random matrix theory denoising. Invest Radiol 2023; 58(10): 720-729.

https://doi.org/10.1097/RLI.0000000000000979

14. Ippoliti S, Fletcher P, Orecchia L, Miano R, Kastner C, Barrett T. Optimal biopsy approach for detection of clinically significant prostate cancer. Br J Radiol 2022;95(1131):20210413.

https://doi.org/10.1259/bjr.20210413

15. AbdelMaboud NM, Elsaid HH, Aboubeih EA. The role of diffusion–Weighted MRI in evaluation of prostate cancer. Egypt J Radiol Nucl Med 2014; 45(1): 231-236.

https://doi.org/10.1016/j.ejrnm.2013.11.010

16. Litjens GJ, Hambrock T, Hulsbergen–van de Kaa C, Barentsz JO, Huisman HJ. Interpatient variation in normal peripheral zone apparent diffusion coefficient: effect on the prediction of prostate cancer aggressiveness. Radiol 2012; 265(1): 260-266.

https://doi.org/10.1148/radiol.12112374

17. Cimadamore A, Cheng L, Lopez-Beltran A, Mazzucchelli R, Lucianò R, Scarpelli M, et al. Added clinical value of whole-mount histopathology of radical prostatectomy specimens: a collaborative review. Euro Urol Oncol 2021; 4(4): 558-569.

https://doi.org/10.1016/j.euo.2020.08.003

18. Saito S, Koyama Y, Ueda J, Hashido T. Relationship between apparent diffusion coefficient distribution and cancer grade in prostate cancer and benign prostatic hyperplasia. Diagnostics 2022; 12(2): 525.

https://doi.org/10.3390/diagnostics12020525

19. Falaschi Z, Tricca S, Attanasio S, Billia M, Airoldi C, Percivale I, et al. Non-timely clinically applicable ADC ratio in prostate mpMRI: a comparison with fusion biopsy results. Abdom Radiol 2022; 47(11): 3855-3867. https://doi.org/10.1007/s00261-022-03627-w

20. Spadarotto N, Sauck A, Hainc N, Keller I, John H, Hohmann J. Quantitative Evaluation of Apparent Diffusion Coefficient Values, ISUP Grades and Prostate-Specific Antigen Density Values of Potentially Malignant PI-RADS Lesions. Cancers 2023; 15(21): 5183. https://doi.org/10.3390/cancers15215183