Transition zone prostate cancer: Incremental value of diffusion-weighted endorectal MR imaging in tumor detection and assessment of aggressiveness Journal Article


Authors: Jung, S.; Donati, O. F.; Vargas, H. A.; Goldman, D.; Hricak, H.; Akin, O.
Article Title: Transition zone prostate cancer: Incremental value of diffusion-weighted endorectal MR imaging in tumor detection and assessment of aggressiveness
Abstract: Purpose: To evaluate the incremental value of using diffusionweighted magnetic resonance (MR) imaging in addition to T2-weighted imaging for the detection of prostate cancer in the transition zone and the assessment of tumor aggressiveness. Materials and Methods: This retrospective HIPAA-compliant institutional review board Capproved study included 156 consecutive patients (median age, 59.2 years) who underwent MR imaging before radical prostatectomy. Two readers who were blinded to patient data independently recorded their levels of suspicion on a five-point scale of the presence of transition zone tumors on the basis of T2-weighted imaging alone and then, 4 weeks later, diffusion-weighted imaging and T2-weighted imaging together. Apparent diffusion coefficients (ADCs) were measured in transition zone cancers and glandular and stromal benign prostatic hyperplasia. Areas under the receiver operating characteristic curves were used to evaluate detection accuracy, and generalized linear models were used to test ADC differences between benign and malignant prostate regions. Whole-mount step-section histopathologic examination was the reference standard. Results: In overall tumor detection, addition of diffusion-weighted imaging to T2-weighted imaging improved the areas under the receiver operating characteristic curves for readers 1 and 2 from 0.60 and 0.60 to 0.75 and 0.71, respectively, at the patient level (P =.004 for reader 1 and P =.027 for reader 2) and from 0.64 and 0.63 to 0.73 and 0.68, respectively, at the sextant level (P =.001 for reader 1 and P =.100 for reader 2). Least squares mean ADCs (× 10-3mm2/sec) in glandular and stromal benign prostatic hyperplasia were 1.44 and 1.09, respectively. Mean ADCs were inversely associated with tumor Gleason scores (1.10, 0.98, 0.87, and 0.75 for Gleason scores of 3 + 3, 3 + 4, 4 + 3, and ≥ 4 + 4, respectively). Conclusion: Use of diffusion-weighted imaging in addition to T2-weighted imaging improved detection of prostate cancer in the transition zone, and tumor ADCs were inversely associated with tumor Gleason scores in the transition zone. q RSNA, 2013 © RSNA, 2013.
Journal Title: Radiology
Volume: 269
Issue: 2
ISSN: 0033-8419
Publisher: Radiological Society of North America, Inc.  
Date Published: 2013-11-01
Start Page: 493
End Page: 503
Language: English
DOI: 10.1148/radiol.13130029
PROVIDER: scopus
PUBMED: 23878284
DOI/URL:
Notes: --- - "Export Date: 2 December 2013" - "CODEN: RADLA" - "Source: Scopus"
Altmetric Score
MSK Authors
  1. Hedvig Hricak
    335 Hricak
  2. Oguz Akin
    179 Akin
  3. Sungil Jung
    4 Jung
  4. Debra Alyssa Goldman
    99 Goldman
  5. Olivio Fabrizio Manolo Donati
    16 Donati