International Journal of Hematology and Oncology 2022, Vol 32, Num 3 Page(s): 088-097
Correlation of Clinical Risk Factors with Diffusion-Weighted Magnetic Resonance Images in Prostate Cancer Patients Treated with Definitive Radiotherapy

Gurcan ERBAY1, Cem ONAL2, Ozan C. GULER2, Elif KARADELI1, Zafer KOC1

1Baskent University Faculty of Medicine, Department of Radiology, Ankara, TURKEY
2Baskent University Faculty of Medicine, Adana Research and Treatment Centre, Department of Radiation Oncology, Adana, TURKEY

Keywords: Prostate cancer, Diffusion-weighted MRI, Risk factors, Apparent diffusion coefficient, Prognostic factor
This study is aimed to correlate apparent diffusion coefficient (ADC) values and clinical T-stage, serum PSA, pathology Gleason scores. We also further analyzed whether ADC values could be used to appropriately define the risk groups. 135 biopsy-proven, radiotherapy-(RT)-treated, prostate cancer patients who underwent pre-RT DW-MRI and standard T2W pelvic MRI were included. ADC and normalized ADC (nADC) values were calculated from DW-MRI delivered a median 8.1 weeks after prostate biopsy. ADC values were correlated with clinical risk factor values by using Pearson correlation test. ADCs in low-, intermediate-, and high-risk patients were 0.873±0.122X10–3 mm2/s, 0.763±0.124X10–3 mm2/s, and 0.701±0.132X10–3 mm2/s (p= 0.001), respectively. Patients with preRT PSA <10 ng/mL had significantly higher ADCs than patients with preRT PSA 10–20 ng/mL (p= 0.02) or >20 ng/mL (p< 0.001). Mean ADC for patients with Gleason score <7 was significantly higher than patients scoring 7 (p= 0.001) or >7 (p < 0.001). Clinical stage < T2b patients had significantly higher ADC values versus stage T2b (p=0.001) and T2b tumors (p< 0.001). ADC demonstrated stronger correlation with NCCN risk groups (R=–0.510; p< 0.001). All clinical factors except Gleason score had moderate inverse correlation with nADC. Best nADC correlation occurred with NCCN risk groups (R=-0.461; p< 0.001). ADCs measured by DW-MRI are noninvasive prognostic markers of clinical parameters and risk for prostate cancer in RT candidates.