title: Apparent diffusion coefficient value as a biomarker reflecting morphological and biological features of prostate cancer.
abstract: OBJECTIVE
  To assess whether there is an association between the apparent diffusion coefficient (ADC) value and the pathological characteristics of prostate cancer.
  
  
  METHODS
  The study cohort consisted of 29 consecutive patients with prostate cancer treated with radical prostatectomy. All patients underwent diffusion-weighted MRI before the prostate biopsy. In 42 tumor foci, the associations of the ADC values with the clinicopathological characteristics and Ki-67 labeling index (LI) were analyzed.
  
  
  RESULTS
  High-grade cancers (Gleason score [GS] ≥ 4 + 3), larger cancers (maximum diameter (MD) ≥ 16 mm), and highly proliferating cancers (Ki-67 LI ≥ 4.43 %) had significantly lower ADC values, respectively (P < .001, P = .008, and P = .044, respectively). There was no significant difference in ADC value according to age, prostate-specific antigen, presence of extra-prostatic extension, and intra-tumoral stroma proportion. Multivariate analysis showed that GS, Ki-67 LI, and MD had independent and significant correlations with ADC value (P < .001, P = .006, and P = .002, respectively). Low ADC tumors (<0.52 × 10(-3) mm(2)/s) are likely to be high-grade cancer foci compared with high ADC tumors (relative risk: 65.2). The sensitivity and specificity of the ADC value to predict high-grade cancer foci are 81.8 and 93.5 %, respectively.
  
  
  CONCLUSIONS
  A low ADC value reflects the morphological and biological features of prostate cancer. Analyzing the ADC value may make it possible to more precisely predict the cancer aggressiveness of each focus before treatment.
authors.forename: Hyeyeol
authors.initials: H
authors.lastname: Bae
authors.forename: Soichiro
authors.initials: S
authors.lastname: Yoshida
authors.forename: Yoh
authors.initials: Y
authors.lastname: Matsuoka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakajima
authors.forename: Eisaku
authors.initials: E
authors.lastname: Ito
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanaka
authors.forename: Miyako
authors.initials: M
authors.lastname: Oya
authors.forename: Takayuki
authors.initials: T
authors.lastname: Nakayama
authors.forename: Hideki
authors.initials: H
authors.lastname: Takeshita
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kijima
authors.forename: Junichiro
authors.initials: J
authors.lastname: Ishioka
authors.forename: Noboru
authors.initials: N
authors.lastname: Numao
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Koga
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Saito
authors.forename: Takumi
authors.initials: T
authors.lastname: Akashi
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Fujii
authors.forename: Kazunori
authors.initials: K
authors.lastname: Kihara
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000737:chemistry / Q000473:pathology* / Q000601:surgery; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D019394:Ki-67 Antigen
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