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KMID : 1011820170580010012
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Investigative and Clinical Urology
2017 Volume.58 No. 1 p.12 ~ p.19
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Predicting biochemical recurrence in patients with high-risk prostate cancer using the apparent diffusion coefficient of magnetic resonance imaging
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Yoon Min-Young
Park Ju-Hyun
Cho Jeong-Yeon
Jeong Chang-Wook
Ku Ja-Hyeon
Kim Hyeon-Hoe
Kwak Cheol
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Abstract
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Purpose: We 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 Methods: A 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.
Results: Group 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.
Conclusions: In 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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KEYWORD
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Magnetic resonance imaging, Prognosis, Prostate neoplasms, Recurrence
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