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Clinical utility of the normalized apparent diffusion coefficient for preoperative evaluation of the aggressiveness of prostate cancer

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Abstract

Purpose

Normalization of the apparent diffusion coefficient (ADC) may overcome ADC variability attributable to different patient and/or technical factors. The purpose of this study was to compare the efficacy of ADC and the normalized ADC (nADC) for differentiating between prostate cancer with a Gleason score (GS) = 6 and GS > 6 and to identify an optimum reference for nADC calculations.

Materials and methods

Our study population comprised 58 patients who underwent diffusion-weighted MRI followed by radical prostatectomy. The nADC of the prostate cancer was calculated as ADC (cancer)/ADC (reference) by using the obturator internus muscle, urine in the bladder, and a 20-ml saline bottle placed on the groin as references. We performed receiver operating characteristic (ROC) analysis to identify the optimum reference for nADC calculations.

Results

To differentiate between GS = 6 and GS > 6 prostate cancer, the area under the ROC curve of the nADC obtained with a saline bottle as reference was best (0.85) and significantly better than the area under the ADC ROC curve (0.71).

Conclusions

nADC is superior to ADC for estimating the aggressiveness of prostate cancer. It is a noninvasive technique that aids in the selection of appropriate treatments.

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Kumamoto, 860-8556, Japan

    Ryo Itatani, Tomohiro Namimoto & Yasuyuki Yamashita

  2. Department of Radiology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto, 862-0965, Japan

    Ryo Itatani, Akira Yoshimura, Kazuhiro Katahira, Seiichiro Noda & Nobuyuki Toyonari

  3. Department of Urology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto, 862-0965, Japan

    Kosuke Kitani & Yasuyuki Hamada

  4. Department of Pathology, Kumamoto Chuo Hospital, 1-5-1, Tainoshima, Kumamoto, 862-0965, Japan

    Mitsuhiko Kitaoka

Authors
  1. Ryo Itatani
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  2. Tomohiro Namimoto
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  3. Akira Yoshimura
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  7. Kosuke Kitani
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  10. Yasuyuki Yamashita
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Correspondence to Ryo Itatani.

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Itatani, R., Namimoto, T., Yoshimura, A. et al. Clinical utility of the normalized apparent diffusion coefficient for preoperative evaluation of the aggressiveness of prostate cancer. Jpn J Radiol 32, 685–691 (2014). https://doi.org/10.1007/s11604-014-0367-0

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  • DOI: https://doi.org/10.1007/s11604-014-0367-0

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