The value of magnetic resonance imaging apparent diffusion coefficient values in predicting Gleason grading of low to intermediate-risk prostate cancer
Objective:To investigate the diagnostic performance of the apparent diffusion coefficient(ADC)for low to intermediate-risk prostate cancer(PCa),as well as its correlation with the prognostic Gleason score(GS).Methods:The images and data from prostate examination patients at Nanjing Drum Tower Hospital were collected for retrospective analysis spanning January 2020 to December 2021.During this analysis,the ADC values of lesions were measured to assess the efficacy of ADC in diagnosing low to intermediate-risk PCa.Additionally,the correla-tion between ADC values and GS was investigated,and the diagnostic efficacy between mean apparent diffusion coef-ficient values(ADCmean)and minimum apparent diffusion coefficient values(ADCmin)was compared.Results:Among the 1 051 patients,there were a total of 1 202 lesions,with 638 cases identified as PCa(53.08%)and 564 cases as benign lesions(46.92%).The benign lesion group exhibited significantly higher ADCmin and ADCmean val-ues compared to the PCa group,and these differences were statistically significant(P<0.01).In terms of GS,the ADCmin and ADCmean values of the GS 4 +3 group were significantly lower than those of the GS 3 +4 group,GS 3 + 3 group,and the benign group,with all differences being statistically significant(P<0.01).The AUC values for diagnosing PCa based on ADCmin and ADCmean were 0.911 and 0.972,respectively.The corresponding diagnostic thresholds were 0.703×10-3 mm2·s-1 for ADCmin and 0.896×10-3 mm2·s-1 for ADCmean.The magnitudes of ADCmin and ADCmean values exhibited a negative correlation with GS values(ρs =-0.764,P<0.001;ρs =-0.845,P<0.001).Conclusion:ADC values demonstrate an inverse relationship with the invasiveness of low to intermediate-risk PCa.They offer notable diagnostic value,particularly in distinguishing between GS 3 +4 and GS 4 +3 lesions,exhibiting both high sensitivity and specificity.Additionally,ADCmean exhibits even greater diagnostic utility,facilitating effective preoperative assessment of PCa's biological attributes.This aids clinicians in formulating treatment strategies and mitigating the risk of excessive therapeutic interventions.
NETL
NSTL
万方数据
维普
