title: Diffusion-weighted magnetic resonance imaging for prediction of insignificant prostate cancer in potential candidates for active surveillance.
abstract: OBJECTIVE
  To investigate whether the apparent diffusion coefficient (ADC) from diffusion-weighted magnetic resonance imaging (DW-MRI) could help improve the prediction of insignificant prostate cancer in candidates for active surveillance (AS).
  
  
  METHODS
  Enrolled in this retrospective study were 287 AS candidates who underwent DW-MRI before radical prostatectomy. Patients were stratified into two groups; Group A consisted of patients with no visible tumour or a suspected tumour ADC value > 0.830 × 10(-3) mm(2)/sec and Group B consisted of patients with a suspected tumour ADC value < 0.830 × 10(-3) mm(2)/sec. We compared pathological outcomes in each group.
  
  
  RESULTS
  Group A had 243 (84.7 %) patients and Group B had 44 (15.3 %) patients. The proportion of organ-confined Gleason ≤ 6 disease and insignificant prostate cancer was significantly higher in Group A than Group B (61.3 % vs. 38.6 %, p = 0.005 and 47.7 % vs. 25.0 %, p = 0.005, respectively). On multivariate analysis, a high ADC value was the independent predictor of organ-confined Gleason ≤ 6 disease and insignificant prostate cancer (odds ratio = 2.43, p = 0.011 and odds ratio = 2.74, p = 0.009, respectively).
  
  
  CONCLUSIONS
  Tumour ADC values may be a useful marker for predicting insignificant prostate cancer in candidates for AS.
  
  
  CONCLUSIONS
  • ADC from DW-MRI can help assess prostate cancer aggressiveness in potential AS candidates. • There was a closed correlation between higher ADC values and insignificant prostate cancer. • The absence of lesions on DWI/DWI can help select potential AS candidates.
authors: Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, # 81 Irwon-Ro, Gangnam-gu, Seoul, 135-710, Republic of Korea.
authors: Tae Heon
authors: TH
authors: Kim
authors: Jae Yong
authors: JY
authors: Jeong
authors: Sin Woo
authors: SW
authors: Lee
authors: Chan Kyo
authors: CK
authors: Kim
authors: Byung Kwan
authors: BK
authors: Park
authors: Hyun Hwan
authors: HH
authors: Sung
authors: Hwang Gyun
authors: HG
authors: Jeon
authors: Byong Chang
authors: BC
authors: Jeong
authors: Seong Il
authors: SI
authors: Seo
authors: Hyun Moo
authors: HM
authors: Lee
authors: Han Yong
authors: HY
authors: Choi
authors: Seong Soo
authors: SS
authors: Jeon
mesh_terms: D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D012669:Seminal Vesicles / Q000473:pathology; D057832:Watchful Waiting
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