Apparent Diffusion Coefficient of Variation (ADCcv): A New Biomarker for Aggressiveness in Prostate Cancer?

Abstract

Objective: The aim of the study was to evaluate which apparent diffusion coefficient (ADC) parameter can predict the aggressiveness of prostate cancer in patients confirmed by radical prostatectomy specimens. Materials and Methods: Patients who underwent radical prostatectomy for prostate cancer between October 2019 and June 2023 were retrospectively reviewed. Patients were separated into two groups based on the International Society of Urological Pathology (ISUP) classification, and the correlation between ADC metrics and ADC parameters, including ADCmean, ADCcoefficient of variation (ADCcv), and ISUP classification the aggressiveness of prostate cancer was studied. Results: Fifty-seven patients were included in the study. Patients were evaluated as low-risk (group 1) (n=40), and high-risk (group) (n=17). ADCmean values for the two groups were not significantly different (p=0.218). ADCcv values that can demonstrate tumour heterogeneity index were higher in group 2 than in group 1 (p<0.001). Multivariate analysis revealed that extracapsular extension, positive surgical margin, and ADCcv values indicated tumour proliferation, whereas seminal vesicle invasion, prostate-specific antigen levels, and body mass index were not correlated with ISUP grade groups. Conclusion: ADCcv is a promising new biomarker for tumour aggressiveness in prostate cancer.

Keywords

• diffusion weighted imaging
• apparent diffusion coefficient
• isup grade group
• prostate cancer
• prostatectomy