MP05-06 DIAGNOSTIC ACCURACY OF ADC VALUE ON BIPARAMETRIC MRI FOR DETECTING CLINICALLY SIGNIFICANT PROSTATE CANCER

Abstract

You have accessJournal of UrologyProstate Cancer: Detection & Screening I (MP05)1 Sep 2021MP05-06 DIAGNOSTIC ACCURACY OF ADC VALUE ON BIPARAMETRIC MRI FOR DETECTING CLINICALLY SIGNIFICANT PROSTATE CANCER Jih Hoon Park, Ja Yoon Ku, and Hong Koo Ha Jih Hoon ParkJih Hoon Park More articles by this author , Ja Yoon KuJa Yoon Ku More articles by this author , and Hong Koo HaHong Koo Ha More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001972.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: PI-RADS v2 is helpful for the detection of clinically significant prostate cancer (CS-PCa), but does not provide quantitative information. We conducted this study to evaluate the diagnostic accuracy of apparent diffusion coefficient (ADC) value for detecting CS-PCa with TRUS-MR fusion biopsy using 3T biparametric MRI (bpMRI). METHODS: We enrolled 310 patients with elevated PSA level over 4 ng/mL who underwent bpMRI followed by TRUS-MR fusion biopsy of prostate between June 2016 and June 2019. Patients underwent MRI examination on Achieva 3.0T TX MRI Scanner from Philips. The suspicious lesions were indicated by experienced radiologists according to PI-RADS v2, marked as a region-of-interest (ROI) and targeted by TRUS-MR fusion biopsy. ADC values were calculated for a pair of b values: 50 and 1400 s/mm2. ADC values of ROIs were recorded by averaging the values measured at least three times each by two urologists. The size of ROIs was chosen to be as large as possible and with minimal contamination from normal tissue. CS-PCa was defined as ISUP grade of 2 or greater. Lower grade (LG) PCa was defined as ISUP grade 1 or 2, and higher grade (HG) as ISUP grade over 2. RESULTS: Of the 502 lesions indicated and biopsied, 348 (69.3%) were on peripheral zone (PZ) and 154 (30.7%) on transitional zone (TZ). In PZ, 101 (29.0%) lesions were diagnosed with PCa, including 73 (21.0%) with CS-PCa, and in TZ, 39 (25.3%) and 21 (13.6%) were detected with PCa and CS-PCa, respectively. Receiver operating characteristic (ROC) curve analyses showed larger area under curve (AUC) for ADC value compared to PI-RADS (0.902 vs 0.827) for detecting CS-PCa in PZ, but not in TZ (0.797 vs 0.786). According to DeLong test there was a statistically significant better AUC for ADC value on ROC curve analysis compared to PI-RADS in PZ (p=0.0095), but not in TZ (p=0.8496). Mean ADC value (x10-3 mm2/s) of the lesions diagnosed with benign prostatic tissues was 0.929 (95% CI 0.906-0.953), and was different statistically significant with that of LG PCa tissues (mean=0.643, 95% CI 0.591-0.695, p<0.001) and that of HG PCa tissue (mean=0.576, 95% CI 0.540-0.610, p<0.001). The difference between LG and HG PCa tissues was statistically significant (p=0.034). CONCLUSIONS: Predictive role of ADC value on biparametric MRI before TRUS-MR fusion biopsy is better than PI-RADS v2 in detection of CS-PCa. Source of Funding: No source of funding © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e79-e80 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jih Hoon Park More articles by this author Ja Yoon Ku More articles by this author Hong Koo Ha More articles by this author Expand All Advertisement Loading ...