Apparent Diffusion Coefficient (ADC) Ratio Versus Conventional ADC for Detecting Clinically Significant Prostate Cancer With 3-T MRI

Bajgiran, Amirhossein Mohammadian; Mirak, Sohrab Afshari; Sung, Kyunghyun; Sisk, Anthony; Reiter, Robert E.; Raman, Steven S.

doi:10.2214/ajr.19.21365

Cited by 34 publications

(44 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As expected, the lowest values were found in PCa patients, suggesting that ADC could be the one biomarker distinguishing PCa from non-PCa lesions. This value is in line with previously published works, confirming the role of low ADC values for csPCa diagnosis [23,27,28]. The MiRNA drivers of disease status could distinguish healthy donors from patients with either ciPCa or csPCa.…”

Section: Discussionsupporting

confidence: 91%

Network Analysis Integrating microRNA Expression Profiling with MRI Biomarkers and Clinical Data for Prostate Cancer Early Detection: A Proof of Concept Study

et al. 2021

View full text Add to dashboard Cite

The MRI of the prostate is the gold standard for the detection of clinically significant prostate cancer (csPCa). Nonetheless, MRI still misses around 11% of clinically significant disease. The aim was to comprehensively integrate tissue and circulating microRNA profiling, MRI biomarkers and clinical data to implement PCa early detection. In this prospective cohort study, 76 biopsy naïve patients underwent MRI and MRI directed biopsy. A sentinel sample of 15 patients was selected for a pilot molecular analysis. Weighted gene coexpression network analysis was applied to identify the microRNAs drivers of csPCa. MicroRNA–target gene interaction maps were constructed, and enrichment analysis performed. The ANOVA on ranks test and ROC analysis were performed for statistics. Disease status was associated with the underexpression of the miRNA profiled; a correlation was found with ADC (r = −0.51, p = 0.02) and normalized ADC values (r = −0.64, p = 0.002). The overexpression of miRNAs from plasma was associated with csPCa (r = 0.72; p = 0.02), and with PI-RADS assessment score (r = 0.73; p = 0.02); a linear correlation was found with biomarkers of diffusion and perfusion. Among the 800 profiled microRNA, eleven were identified as correlating with PCa, among which miR-548a-3p, miR-138-5p and miR-520d-3p were confirmed using the RT-qPCR approach on an additional cohort of ten subjects. ROC analysis showed an accuracy of >90%. Provided an additional validation set of the identified miRNAs on a larger cohort, we propose a diagnostic paradigm shift that sees molecular data and MRI biomarkers as the prebiopsy triage of patients at risk for PCa. This approach will allow for accurate patient allocation to biopsy, and for stratification into risk group categories, reducing overdiagnosis and overtreatment.

show abstract

Section: Discussionsupporting

confidence: 91%

Network Analysis Integrating microRNA Expression Profiling with MRI Biomarkers and Clinical Data for Prostate Cancer Early Detection: A Proof of Concept Study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…The simulation results shown in Fig. 4 revealed that a two‐point analysis 10,11 and analyses with three or more fit points 12–18 produced clearly different ADCs. Below a maximum b ‐value of 500 seconds/mm 2 the resulting difference could be considered negligible; however, with rising maximum b ‐value the difference became increasingly manifest.…”

Section: Resultsmentioning

confidence: 94%

Prostate Cancer Diffusion‐Weighted Magnetic Resonance Imaging: Does the Choice of Diffusion‐Weighting Level Matter?

Maier

Wallström

Langkilde

et al. 2021

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Background Diffusion‐weighted magnetic resonance imaging plays an important role in multiparametric assessment of prostate lesions. The derived apparent diffusion coefficient (ADC) could be a useful quantitative biomarker for malignant growth, but lacks acceptance because of low reproducibility. Purpose To investigate the impact of the choice of diffusion‐weighting levels (b‐values) on contrast‐to‐noise ratio and quantitative measures in prostate diffusion‐weighted MRI. Study Type Retrospective and simulation based on published data. Subjects Patient cohort (21 men with Prostate Imaging‐Reporting and Data System (PI‐RADS) version 2 score ≥3) from a single‐center study. Field Strength/Sequence 3 T/diffusion‐weighted imaging with single‐shot echo‐planar imaging. Assessment Both clinical data and simulations based on previously acquired data were used to quantify the influence of b‐value choice in normal peripheral zone (PZ) and PZ tumor lesions. For clinical data, ADC was determined for different combinations of b‐values. Contrast‐to‐noise ratio and quantitative diffusion measures were simulated for a wide range of b‐values. Statistical Tests Tissue ADC and the lesion‐to‐normal tissue ADC ratios of different b‐value combinations were compared with paired two‐tailed Student's t‐tests. A P‐value <0.05 was considered statistically significant. Results Findings about b‐value dependence derived from clinical data and from simulations agreed with each other. Provided measurement was limited to two b‐values, simulation‐derived optimal b‐value choices coincided with PI‐RADSv2 recommendations. For two‐point measurements, ADC decreased by 15% when the maximum b‐value increased from 1000 to 1500 seconds/mm2, but corresponding lesion‐to‐normal tissue ADC ratio showed no significant change (P = 0.86 for acquired data). Simulations with three or more measurement points produced ADCs that declined by only 8% over this range of maximum b‐value. Corresponding ADC ratios declined between 2.6% (three points) and 3.8% (21 points). Simulations also revealed an ADC reduction of about 19% with the shorter echo and diffusion time evaluated. Data Conclusion The comprehensive assessment of b‐value dependence permits better formulation of protocol and analysis recommendations for obtaining reproducible results in prostate cancer diffusion‐weighted MRI. Level of Evidence 4 Technical Efficacy Stage 2

show abstract

“…The readers manually drew three ROIs on sDWI, one each for the MRI-suggested index lesion and bP and pP regions on sDWI. The MRI-suggested bP region was measured in the contralateral peripheral zone (PZ) or transition zone (TZ), depending on the zonal location of the MRI-suggested index lesion (i.e., when the index legion was located in the PZ, the bP region was measured in the contralateral PZ) [ 12 13 14 ]. Since the lesion visibility could be closely related to the relative signal difference between the lesion and the benign prostatic region, we measured the SI for the part showing benign MRI findings on the contralateral side of the prostate.…”

Section: Methodsmentioning

confidence: 99%

Why Is a b-value Range of 1500–2000 s/mm² Optimal for Evaluating Prostatic Index Lesions on Synthetic Diffusion-Weighted Imaging?

Yeon

Kim²,

Park

2021

Korean J Radiol

View full text Add to dashboard Cite

Objective It is uncertain why a b-value range of 1500–2000 s/mm 2 is optimal. This study was aimed at qualitatively and quantitatively analyzing the optimal b-value range of synthetic diffusion-weighted imaging (sDWI) for evaluating prostatic index lesions. Materials and Methods This retrospective study included 92 patients who underwent DWI and targeted biopsy for magnetic resonance imaging (MRI)-suggested index lesions. We generated sDWI at a b-value range of 1000–3000 s/mm 2 using dedicated software and true DWI data at b-values of 0, 100, and 1000 s/mm 2 . We hypothesized that lesion conspicuity would be best when the background (i.e., MRI-suggested benign prostatic [bP] and periprostatic [pP] regions) signal intensity (SI) is suppressed and becomes homogeneous. To prove this hypothesis, we performed both qualitative and quantitative analyses. For qualitative analysis, two independent readers analyzed the b-value showing the best visual conspicuity of an MRI-suggested index lesion. For quantitative analysis, the readers assessed the b-value showing the same bP and pP region SI. The 95% confidence interval (CI) or interquartile range of qualitatively and quantitatively selected optimal b-values was assessed, and the mean difference between qualitatively and quantitatively selected b-values was investigated. Results The 95% CIs of optimal b-values from qualitative and quantitative analyses were 1761–1805 s/mm 2 and 1640–1771 s/mm 2 (median, 1790 s/mm 2 vs. 1705 s/mm 2 ; p = 0.003) for reader 1, and 1835–1895 s/mm 2 and 1705–1841 s/mm 2 (median, 1872 s/mm 2 vs. 1763 s/mm 2 ; p = 0.022) for reader 2, respectively. Interquartile ranges of qualitatively and quantitatively selected optimal b-values were 1735–1873 s/mm 2 and 1573–1867 s/mm 2 for reader 1, and 1775–1945 s/mm 2 and 1591–1955 s/mm 2 for reader 2, respectively. Bland–Altman plots consistently demonstrated a mean difference of less than 100 s/mm 2 between qualitatively and quantitatively selected optimal b-values. Conclusion b-value range showing a homogeneous background signal may be optimal for evaluating prostatic index lesions on sDWI. Our qualitative and quantitative data consistently recommend b-values of 1500–2000 s/mm 2 .

show abstract

Apparent Diffusion Coefficient (ADC) Ratio Versus Conventional ADC for Detecting Clinically Significant Prostate Cancer With 3-T MRI

Cited by 34 publications

References 24 publications

Network Analysis Integrating microRNA Expression Profiling with MRI Biomarkers and Clinical Data for Prostate Cancer Early Detection: A Proof of Concept Study

Network Analysis Integrating microRNA Expression Profiling with MRI Biomarkers and Clinical Data for Prostate Cancer Early Detection: A Proof of Concept Study

Prostate Cancer Diffusion‐Weighted Magnetic Resonance Imaging: Does the Choice of Diffusion‐Weighting Level Matter?

Why Is a b-value Range of 1500–2000 s/mm² Optimal for Evaluating Prostatic Index Lesions on Synthetic Diffusion-Weighted Imaging?

Contact Info

Product

Resources

About

Apparent Diffusion Coefficient (ADC) Ratio Versus Conventional ADC for Detecting Clinically Significant Prostate Cancer With 3-T MRI

Cited by 34 publications

References 24 publications

Network Analysis Integrating microRNA Expression Profiling with MRI Biomarkers and Clinical Data for Prostate Cancer Early Detection: A Proof of Concept Study

Network Analysis Integrating microRNA Expression Profiling with MRI Biomarkers and Clinical Data for Prostate Cancer Early Detection: A Proof of Concept Study

Prostate Cancer Diffusion‐Weighted Magnetic Resonance Imaging: Does the Choice of Diffusion‐Weighting Level Matter?

Why Is a b-value Range of 1500–2000 s/mm2 Optimal for Evaluating Prostatic Index Lesions on Synthetic Diffusion-Weighted Imaging?

Contact Info

Product

Resources

About

Why Is a b-value Range of 1500–2000 s/mm² Optimal for Evaluating Prostatic Index Lesions on Synthetic Diffusion-Weighted Imaging?