title: Quantified analysis of histological components and architectural patterns of gleason grades in apparent diffusion coefficient restricted areas upon diffusion weighted MRI for peripheral or transition zone cancer locations.
abstract: To quantify and compare the histological components and architectural patterns of Gleason grades in cancerous areas with restriction on apparent diffusion coefficient (ADC) maps.
  
  
  
  Twelve consecutive cases with 14 separate ADC restriction areas, positive for cancer in the peripheral zone (PZ) and transition zone (TZ) were included. All had 3 Tesla MRI and radical prostatectomy. Ten regions of interest (ROIs) within and outside the 14 ADC restriction areas positive for cancer were selected. For each ROI, we performed quantitative analysis of (a) prostate benign and malignant histological component surface ratios, including stroma, glands, epithelium, lumen, cellular nuclei; (b) percent of Gleason grades and measures of ADC values. Means of histological components according to ADC restriction for cancerous area were compared with analyses of variance with repeated measures.
  
  
  
  Independent predictors of the probability of cancer were median epithelium/ROI ratio (P = 0.001) and nuclei/ROI ratio (P = 0.03). Independent predictors of the probability of ADC restriction were malignant glands/ROI and luminal space/ROI (P < 0.0001). Effect of malignant glands/ROI area was different according to the localization of the ROI (P = 0.03). We observed an overall difference between the means for all of the histological components for the comparison of true positive and false negative (P < 0.0001), except for the percent of Gleason grade 4 (P = 0.18). In TZ cancers, a predominant grade 3 pattern was associated with low ADC values. In PZ cancers, a predominant grade 4 pattern was associated with low ADC values.
  
  
  
  Determinants of low ADC were high ratio of malignant glands/ROI area which may be seen in Gleason grades 3 or 4 cancers.
  
  
  
  3 Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2017;46:1786-1796.
authors.affiliation: Department of Urology, CHRU Lille, Lille university, Lille, France.|Inserm, U1189 - ONCO-THAI, CHRU Lille, Lille university, France.
authors.forename: Olivier
authors.identifier: 0000-0002-8203-2676
authors.initials: O
authors.lastname: Helfrich
authors.affiliation: Inserm, U1189 - ONCO-THAI, CHRU Lille, Lille university, France.|Department of Radiology, CHRU Lille, Lille university, Lille, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Puech
authors.affiliation: Inserm, U1189 - ONCO-THAI, CHRU Lille, Lille university, France.
authors.forename: Nacim
authors.initials: N
authors.lastname: Betrouni
authors.affiliation: EA 2694 - Lille university, Santé publique: épidémiologie et qualité des soins, Lille, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Pinçon
authors.affiliation: Department of Urology, CHRU Lille, Lille university, Lille, France.|Inserm, U1189 - ONCO-THAI, CHRU Lille, Lille university, France.
authors.forename: Adil
authors.initials: A
authors.lastname: Ouzzane
authors.affiliation: Department of Urology, CHRU Lille, Lille university, Lille, France.|Inserm, U1189 - ONCO-THAI, CHRU Lille, Lille university, France.
authors.forename: Jérome
authors.initials: J
authors.lastname: Rizk
authors.affiliation: Department of Urology, CHRU Lille, Lille university, Lille, France.
authors.forename: Gauthier
authors.initials: G
authors.lastname: Marcq
authors.affiliation: Department of Urology, University Hospital Zürich, Zürich, Switzerland.
authors.forename: Marco
authors.initials: M
authors.lastname: Randazzo
authors.affiliation: Department of Urology, CHU Nice, Nice-Sophia-Antipolis University, France.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Durand
authors.affiliation: Inserm, U1189 - ONCO-THAI, CHRU Lille, Lille university, France.
authors.forename: Said
authors.initials: S
authors.lastname: Lakroum
authors.affiliation: Department of Pathology, CHRU Lille, Lille university, Lille, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Leroy
authors.affiliation: Department of Urology, CHRU Lille, Lille university, Lille, France.|Inserm, U1189 - ONCO-THAI, CHRU Lille, Lille university, France.
authors.forename: Arnauld
authors.initials: A
authors.lastname: Villers
mesh_terms: D000368:Aged; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D060787:Neoplasm Grading; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D015203:Reproducibility of Results
keywords: Gleason grading; diffusion magnetic resonance imaging; prostate neoplasms