Determination of the cutoff level of apparent diffusion coefficient values for detection of prostate cancer

Nagayama, Masako; Watanabe, Yuji; Terai, Akito; Araki, Tohru; Notohara, Kenji; Okumura, Akihisa; Amoh, Yoshiki; Ishimori, Takayoshi; Nakashita, Satoru; Dodo, Yukio

doi:10.1007/s11604-011-0586-6

Cited by 18 publications

(12 citation statements)

References 39 publications

(77 reference statements)

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“…These results are consistent with results previously published [17-19]. The mean ADC for positive PCa cores in our group (0.79 ± 0.18 × 10 -3 mm 2 /s) was slightly higher than the one reported by Woodfield et al [14] (0.737 ± 0.154 × 10 -3 mm 2 /s, range, 0.108–1.263 × 10 -3 ) but lower than results published recently by Yamamura et al [18] (0.96 ± 0.24 × 10 -3 mm 2 /s), Rinaldi et al [19] (0.99 ± 0.15 × 10 -3 mm 2 /s) and Nagayama et al [20] (1.07 ± 0.35 × 10 -3 mm 2 /s) (p > 0.5). The lower ADCs for positive cores in our study group were probably because of the high number of Gleason score 8 and 9 biopsy-proven sectors, which exceeded 60% of all PCa positive biopsies.…”

Section: Discussionmentioning

confidence: 58%

Evaluation of the normal-to-diseased apparent diffusion coefficient ratio as an indicator of prostate cancer aggressiveness

et al. 2014

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BackgroundWe tested the feasibility of a simple method for assessment of prostate cancer (PCa) aggressiveness using diffusion-weighted magnetic resonance imaging (MRI) to calculate apparent diffusion coefficient (ADC) ratios between prostate cancer and healthy prostatic tissue.MethodsThe requirement for institutional review board approval was waived. A set of 20 standardized core transperineal saturation biopsy specimens served as the reference standard for placement of regions of interest on ADC maps in tumorous and normal prostatic tissue of 22 men with PCa (median Gleason score: 7; range, 6–9). A total of 128 positive sectors were included for evaluation. Two diagnostic ratios were computed between tumor ADCs and normal sector ADCs: the ADC peripheral ratio (the ratio between tumor ADC and normal peripheral zone tissue, ADC-PR), and the ADC central ratio (the ratio between tumor ADC and normal central zone tissue, ADC-CR). The performance of the two ratios in detecting high-risk tumor foci (Gleason 8 and 9) was assessed using the area under the receiver operating characteristic curve (AUC).ResultsBoth ADC ratios presented significantly lower values in high-risk tumors (0.48 ± 0.13 for ADC-CR and 0.40 ± 0.09 for ADC-PR) compared with low-risk tumors (0.66 ± 0.17 for ADC-CR and 0.54 ± 0.09 for ADC-PR) (p < 0.001) and had better diagnostic performance (ADC-CR AUC = 0.77, sensitivity = 82.2%, specificity = 66.7% and ADC-PR AUC = 0.90, sensitivity = 93.7%, specificity = 80%) than stand-alone tumor ADCs (AUC of 0.75, sensitivity = 72.7%, specificity = 70.6%) for identifying high-risk lesions.ConclusionsThe ADC ratio as an intrapatient-normalized diagnostic tool may be better in detecting high-grade lesions compared with analysis based on tumor ADCs alone, and may reduce the rate of biopsies.

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Section: Discussionmentioning

confidence: 58%

Evaluation of the normal-to-diseased apparent diffusion coefficient ratio as an indicator of prostate cancer aggressiveness

et al. 2014

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“…The cutoff value of 746×10 −6 mm 2 /s was chosen to maximize the discriminatory ability related to sensitivity and specificity (Fig. 2) [20]. Next, the patients were stratified into 2 groups according to this cutoff value; Group A comprised patients with measured tumor ADC values <746×10 −6 mm 2 /s while group B patients had measured tumor ADC values ≥746×10 −6 mm 2 /s.…”

Section: Resultsmentioning

confidence: 99%

Predicting biochemical recurrence in patients with high-risk prostate cancer using the apparent diffusion coefficient of magnetic resonance imaging

et al. 2017

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PurposeWe aimed to investigate whether the apparent diffusion coefficient (ADC) value in diffusion-weighted magnetic resonance imaging predicts the prognoses of patients with high-risk prostate cancer.Materials and MethodsA total of 157 patients with high-risk prostate cancer (based on D'Amico's criteria) were included in the analysis. Patients underwent preoperative 3.0 Tesla magnetic resonance imaging within 2 months before radical prostatectomy. Those who received neoadjuvant hormone therapy (33 persons) or radiation therapy (18 persons) were excluded. The ADC of the tumor calculated from 2 b-values (0 and 1,000 s/mm2) was measured. Areas under receiver operating characteristics curves were calculated to maximize the accuracy of the ADC value. Based on the obtained cutoff value, the patients were stratified into 2 groups: Group A consisted of patients with ADC values <746×10−6 mm2/s and group B comprised those with ADC values ≥746×10−6 mm2/s.ResultsGroup A showed higher rate of lymph positive and biochemical recurrence (BCR) rates than group B. Kaplan-Meier analysis showed that the BCR-free survival rate of group A was much lower than that of group B (p<0.001). On Cox proportional regression analyses, ADC group A (hazard ratio [HR], 3.238, p=0.002) and pathologic lymph node positive (HR, 2.242; p=0.009) were independent predictors of BCR.ConclusionsIn patients with high-risk prostate cancer, ADC value is significantly associated with BCR-free survival. Therefore, the ADC value is a useful tool for predicting the prognoses of these high-risk patients.

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“…Finally, the considerable overlap of ADC between cancer and noncancerous tissue made it difficult to determine a cutoff value which might be a source of statistical heterogeneity. [52] …”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of DWI in patients with ovarian cancer

Yuan¹,

Guo

Du³

et al. 2017

Medicine

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Background:Diffusion weighted imaging (DWI) is recently developed for identifying different malignant tumors. In this article the diagnostic accuracy of DWI for ovarian cancer was evaluated by synthesis of published data.Methods:A comprehensive literature search was conducted in PubMed/MEDLINE and Embase databases on the diagnostic performance of DWI for ovarian cancer published in English. Methodological quality was evaluated following Quality Assessment for Studies of Diagnostic Accuracy 2 (QUADAS 2) tool. We adopted the summary receiver operating characteristic (SROC) curve to assess the DWI accuracy.Results:Twelve studies including 1142 lesions were analyzed in this meta-analysis to estimate the pooled Sen (sensitivity), Spe (specificity), PLR (positive likelihood ratio), NLR (negative likelihood ratio), and construct SROC (summary receiver operating characteristics) curve. The pooled Sen and Spe were 0.86 (95% confidence interval [CI], 0.83–0.89) and 0.81 (95%CI, 0.77–0.84), respectively. The pooled PLR and pooled NLR were 5.07 (95%CI, 3.15–8.16) and 0.17 (95%CI, 0.10–0.30), respectively. The pooled diagnostic odds ratio (DOR) was 35.23 (95%CI, 17.21–72.14). The area under the curve (AUC) was 0.9160.Conclusion:DWI had moderately excellent diagnostic ability for ovarian cancer and promised to be a helpful diagnostic tool for patients of ovarian cancer.

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Determination of the cutoff level of apparent diffusion coefficient values for detection of prostate cancer

Abstract: The cutoff ADC level determined on the basis of the results obtained from radical prostatectomy specimens can help differentiate malignant from nonmalignant lesions.

Cited by 18 publications

References 39 publications

Evaluation of the normal-to-diseased apparent diffusion coefficient ratio as an indicator of prostate cancer aggressiveness

Evaluation of the normal-to-diseased apparent diffusion coefficient ratio as an indicator of prostate cancer aggressiveness

Predicting biochemical recurrence in patients with high-risk prostate cancer using the apparent diffusion coefficient of magnetic resonance imaging

Diagnostic accuracy of DWI in patients with ovarian cancer

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