title: Can DW-MRI, with its ADC values, be a reliable predictor of biopsy outcome in patients with suspected prostate cancer?
abstract: To relate the multiparametric magnetic resonance imaging (mp-MRI) of patients with suspect peripheral prostate cancer (PCa) to the results of the subsequent biopsy: in particular to explore whether DWI and ADC can predict the biopsy outcome and to investigate the relation between ADC and Gleason score (GS).
  
  
  
  175 consecutive patients who underwent 1.5 T mp-MRI followed by prostate biopsy were retrospectively analyzed by two independent radiologists. ADC values were measured in the peripheral suspect lesion areas (ADCSL) and in the contralateral zones (ADCNSL) obtaining ADCnorm = ADCSL/ADCNSL. Results on T2W images, DWI, ADC values, and perfusion studies were matched to their corresponding biopsy.
  
  
  
  Negative DWI and T2W had 100% negative predictive value (NPV). When DWI was positive, ADCSL > 0.90 × 10 > 0.90 × 10(-3) mm(2)/s (ADCnorm > 0.60) identified by the ROC curve (AUC = 0.80) corresponded to NPV = 85%. In positive biopsies, ADCSL and ADCnorm decreased significantly from GS = 6 to GS ≥ 8 with Spearman coefficient ρ = -0.40 and ROC curve AUC = 0.72.
  
  
  
  mp-MRI allows a reliable prediction of a negative biopsy through the values of DWI, T2W, and ADC. In positive biopsies, there is a moderate correlation between ADC and the various GS levels.
authors.affiliation: Radiology Unit, Department of Surgical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy. riccardo_faletti@yahoo.it.
authors.forename: R
authors.initials: R
authors.lastname: Faletti
authors.affiliation: Radiology Unit, Department of Surgical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Battisti
authors.affiliation: Radiology Unit, Department of Surgical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Discalzi
authors.affiliation: Radiology Unit, Department of Surgical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: M L
authors.initials: ML
authors.lastname: Grognardi
authors.affiliation: Radiology Unit, Department of Surgical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Martinello
authors.affiliation: Urology Unit, Department of Surgical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Oderda
authors.affiliation: Urology Unit, Department of Surgical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Gontero
authors.affiliation: Department of Surgical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Bergamasco
authors.affiliation: Radiology Unit, Department of Surgical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: M C
authors.initials: MC
authors.lastname: Cassinis
authors.affiliation: Radiology Unit, Department of Surgical Sciences, University of Torino, Via Genova 3, 10126, Turin, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Fonio
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D061705:Image-Guided Biopsy; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D018084:Ultrasonography, Interventional
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen
keywords: Biopsy; Diffusion magnetic resonance imaging; Gleason score; Magnetic resonance imaging; Prostatic neoplasms