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Erschienen in: European Radiology 8/2012

01.08.2012 | Urogenital

Diagnostic value of ADC in patients with prostate cancer: influence of the choice of b values

verfasst von: Gregor Thörmer, Josephin Otto, Martin Reiss-Zimmermann, Matthias Seiwerts, Michael Moche, Nikita Garnov, Toni Franz, Minh Do, Jens-Uwe Stolzenburg, Lars-Christian Horn, Thomas Kahn, Harald Busse

Erschienen in: European Radiology | Ausgabe 8/2012

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Abstract

Objectives

To evaluate the influence of the choice of b values on the diagnostic value of the apparent diffusion coefficient (ADC) for detection and grading of prostate cancer (PCa).

Methods

Forty-one patients with biopsy-proven PCa underwent endorectal 3-T MRI before prostatectomy. Different combinations of b values (0–800 s/mm2) were used to calculate four representative ADC maps. Mean ADCs of tumours and non-malignant tissue were determined. Tumour appearance on different ADC maps was rated by three radiologists as good, fair or poor by assigning a visual score (VS) of 2, 1 or 0, respectively. Differences in the ADC values with the choice of b values were analysed using one-way ANOVA.

Results

Choice of b values had a highly (P < 0.001) significant influence on the absolute ADC in each tissue. Maps using b = [50, 800] and [0, 800] were rated best (VS = 1.6 ± 0.3) and second best (1.1 ± 0.3, P < 0.001), respectively. For low-grade carcinomas (Gleason score ≤ 6, 13/41 patients), only the former choice received scores better than fair (VS = 1.4 ± 0.3). Mean tumour ADCs showed significant negative correlation (Spearman’s ρ −0.38 to −0.46, P < 0.05) with Gleason score.

Conclusions

Absolute ADC values strongly depend on the choice of b values and therefore should be used with caution for diagnostic purposes. A minimum b value greater than zero is recommended for ADC calculation to improve the visual assessment of PCa in ADC maps.

Key Points

Absolute ADC values are highly dependent on the choice of b values.
Absolute ADC thresholds should be used carefully to predict tumour aggressiveness.
Subjective ratings of ADC maps involving b = 0 s/mm 2 are poor to fair.
Minimum b value greater than 0 s/mm 2 is recommended for ADC calculation.
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Metadaten
Titel
Diagnostic value of ADC in patients with prostate cancer: influence of the choice of b values
verfasst von
Gregor Thörmer
Josephin Otto
Martin Reiss-Zimmermann
Matthias Seiwerts
Michael Moche
Nikita Garnov
Toni Franz
Minh Do
Jens-Uwe Stolzenburg
Lars-Christian Horn
Thomas Kahn
Harald Busse
Publikationsdatum
01.08.2012
Verlag
Springer-Verlag
Erschienen in
European Radiology / Ausgabe 8/2012
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-012-2432-3

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