Incremental prognostic value of ADC histogram analysis in patients with high-risk prostate cancer receiving adjuvant hormonal therapy after radical prostatectomy.

PURPOSE

To investigate the incremental prognostic value of preoperative apparent diffusion coefficient (ADC) histogram analysis in patients with high-risk prostate cancer (PCa) who received adjuvant hormonal therapy (AHT) after radical prostatectomy (RP).

METHODS

Sixty-two PCa patients in line with the criteria were enrolled in this study. The 10, 50, and 90 percentiles of ADC (ADC, ADC, ADC), the mean value of ADC (ADC), kurtosis, and skewness were obtained from the whole-lesion ADC histogram. The Kaplan-Meier method and Cox regression analysis were used to analyze the relationship between biochemical recurrence-free survival (BCR-fs) and ADC parameters and other clinicopathological factors. Prognostic models were constructed with and without ADC parameters.

RESULTS

The median follow-up time was 53.4 months (range, 41.1-79.3 months). BCR was found in 19 (30.6%) patients. Kaplan-Meier curves showed that lower ADC, ADC, ADC, and ADC and higher kurtosis could predict poorer BCR-fs (all <0.05). After adjusting for clinical parameters, ADC and kurtosis remained independent prognostic factors for BCR-fs (HR: 0.172, 95% CI: 0.055-0.541, =0.003; HR: 7.058, 95% CI: 2.288-21.773, =0.001, respectively). By adding ADC parameters to the clinical model, the C index and diagnostic accuracy for the 24- and 36-month BCR-fs were improved.

CONCLUSION

ADC histogram analysis has incremental prognostic value in patients with high-risk PCa who received AHT after RP. Combining ADC, kurtosis and clinical parameters can improve the accuracy of BCR-fs prediction.