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Diffusion-weighted Endorectal MR Imaging at 3T for Prostate Cancer: Correlation with Tumor Cell Density and Percentage Gleason Pattern on Whole Mount Pathology

1Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
2Department of Radiology, Charité University Hospital, Berlin, Germany.
3Division of Anatomical Pathology, The Ottawa Hospital, Ottawa, ON, Canada.
4Department of Pathology, Humber River Hospital, Toronto, ON, Canada.
5Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
6Department of Radiology, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Publication Date:
Abdom Radiol (NY)
Volume Number:
Issue Number:
Abdom Radiol (NY). 2017 Mar;42(3):918-25.
PubMed ID:
ADC, DWI, Gleason pattern, MRI, Prostate cancer
Appears in Collections:
NCIGT, Prostate Group, SLICER, SPL
R01 CA160902/CA/NCI NIH HHS/United States
U01 CA151261/CA/NCI NIH HHS/United States
U24 CA180918/CA/NCI NIH HHS/United States
P41 EB015898/EB/NIBIB NIH HHS/United States
R25 CA089017/CA/NCI NIH HHS/United States
Generated Citation:
Glazer D.I., Hassanzadeh E., Fedorov A., Olubiyi O.I., Goldberger S.S., Penzkofer T., Flood T.A., Masry P., Mulkern R.V., Hirsch M.S., Tempany C.M., Fennessy F.M. Diffusion-weighted Endorectal MR Imaging at 3T for Prostate Cancer: Correlation with Tumor Cell Density and Percentage Gleason Pattern on Whole Mount Pathology. Abdom Radiol (NY). 2017 Mar;42(3):918-25. PMID: 27770164. PMCID: PMC5357151.
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To determine if tumor cell density and percentage of Gleason pattern within an outlined volumetric tumor region of interest (TROI) on whole-mount pathology (WMP) correlate with apparent diffusion coefficient (ADC) values on corresponding TROIs outlined on pre-operative MRI. METHODS: Men with biopsy-proven prostate adenocarcinoma undergoing multiparametric MRI (mpMRI) prior to prostatectomy were consented to this prospective study. WMP and mpMRI images were viewed using 3D Slicer and each TROI from WMP was contoured on the high b-value ADC maps (b0, 1400). For each TROI outlined on WMP, TCD (tumor cell density) and the percentage of Gleason pattern 3, 4, and 5 were recorded. The ADCmean, ADC10th percentile, ADC90th percentile, and ADCratio were also calculated in each case from the ADC maps using 3D Slicer. RESULTS: Nineteen patients with 21 tumors were included in this study. ADCmean values for TROIs were 944.8 ± 327.4 vs. 1329.9 ± 201.6 mm2/s for adjacent non-neoplastic prostate tissue (p < 0.001). ADCmean, ADC10th percentile, and ADCratio values for higher grade tumors were lower than those of lower grade tumors (mean 809.71 and 1176.34 mm2/s, p = 0.014; 10th percentile 613.83 and 1018.14 mm2/s, p = 0.009; ratio 0.60 and 0.94, p = 0.005). TCD and ADCmean (ρ = -0.61, p = 0.005) and TCD and ADC10th percentile (ρ = -0.56, p = 0.01) were negatively correlated. No correlation was observed between percentage of Gleason pattern and ADC values. CONCLUSION: DWI MRI can characterize focal prostate cancer using ADCratio, ADC10th percentile, and ADCmean, which correlate with pathological tumor cell density.

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