Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-gu, Seoul, Republic of Korea.
Eur Radiol. 2011 May;21(5):1111-8. doi: 10.1007/s00330-010-1999-9. Epub 2010 Nov 3.
To retrospectively assess the apparent diffusion coefficient (ADC) as a predictor of biochemical recurrence (BCR) after surgery in patients with localised prostate cancer.
Enrolled in this study were 158 men who underwent surgery between 2005 and 2007 with preoperative diffusion-weighted MR imaging (DWI) at 3 T, and who received follow-up for a median of 24 months (range, 12-57 months). Univariate and multivariate analyses including all clinical variables and tumour ADC data were performed with respect to BCR. Receiver operating characteristic (ROC) analysis was also performed to assess diagnostic performance of variables in the prediction of BCR.
Thirty patients (19%) who received surgery had BCR. Univariate analysis revealed that tumour ADC, Gleason score at biopsy and surgical specimen, serum PSA, greatest percentage of cancer in biopsy core, percentage of positive cores in all biopsy cores and tumour volume were all significantly related to BCR. However, multivariate analysis identified tumour ADC as the only independently predictive factor. For predicting BCR, area under the curve for tumour ADC was 0.755, and tumour ADC showed better diagnostic performance than that of all other variables.
Tumour ADC on DWI may be a predictive biomarker for BCR following radical prostatectomy.
回顾性评估表观扩散系数（ADC）作为预测局限性前列腺癌患者手术后生化复发（BCR）的指标。
本研究纳入了 158 名男性患者，他们在 2005 年至 2007 年间接受了手术，术前在 3T 进行了弥散加权磁共振成像（DWI）检查，并接受了中位随访 24 个月（范围为 12-57 个月）。对所有临床变量和肿瘤 ADC 数据进行了单因素和多因素分析，以评估其与 BCR 的关系。还进行了受试者工作特征（ROC）分析，以评估变量在预测 BCR 方面的诊断性能。
30 名（19%）接受手术的患者发生了 BCR。单因素分析显示，肿瘤 ADC、活检和手术标本的 Gleason 评分、血清 PSA、活检核心中癌症的最大百分比、所有活检核心中阳性核心的百分比和肿瘤体积均与 BCR 显著相关。然而，多因素分析确定肿瘤 ADC 是唯一的独立预测因素。对于预测 BCR，肿瘤 ADC 的曲线下面积为 0.755，肿瘤 ADC 的诊断性能优于其他所有变量。
DWI 上的肿瘤 ADC 可能是预测根治性前列腺切除术后 BCR 的生物标志物。
