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Threshold-based parametric analysis of diffusion-weighted magnetic resonance imaging at 3.0 Tesla to identify men with prostate cancer

Diarmaid C Moran ()
Laure Marignol ()
Andrew J Fagan ()
Ruth Dunne ()
Antoinette S Perry ()
Dearbhail O'Driscoll ()
Eoin Gaffney ()
Thomas H Lynch ()
James F M Meaney ()
Donal H Hollywood ()


The aim of this study is to determine the accuracy of three apparent diffusion coefficient (ADC) threshold values in detecting prostate cancer (PCa) prior to prostate biopsy. 60 men with clinical suspicion of PCa underwent endorectal diffusion-weighted magnetic resonance imaging (DW-MRI) at 3.0 Tesla (T). Three ADC threshold values (tADC: 1.0, 1.2 and 1.4 × 10-3 mm2/s) were sequentially applied to ADC maps for the detection of malignant lesions in the prostatic peripheral zone (PZ). Segment-based and patient-specific PCa detection performance of these tADC values was correlated with the histopathological results from the subsequent 12-core transrectal ultrasound (TRUS)-guided biopsy. Mean of ADC and area size of the identified malignant region of interests (ROIs) were recorded. Accuracy for PCa detection was assessed by receiver operating characteristic curves. 1.0 × 10-3 mm2/s of tADC provided 79% sensitivity, 97% specificity and 93% positive predictive value for PCa. Area size of the malignant ROI was a good independent factor for PCa detection (AUC = 0.85). ROI area size 0.2 cm2 was identified as the best performing cut-off values for the detection of PCa. Refined detection criteria combining area size ≤0.2 cm2 and ADC <1.0 × 10-3 mm2/s increased the detection performance. In conclusion, threshold-based parametric evaluation of DW-MRI at 3.0 T can detect PZ PCa accurately prior to biopsy.


diffusion-weighted magnetic resonance imaging (DW-MRI); prostatic neoplasm; early detection of cancer; receiver operating characteristic (ROC) curve; histology

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Copyright (c) 2018 Diarmaid C Moran, Laure Marignol, Andrew J Fagan, Ruth Dunne, Antoinette S Perry, Dearbhail O'Driscoll, Eoin Gaffney, Thomas H Lynch, James F M Meaney, Donal H Hollywood

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