Role of DWI/ADC in the Assessment of Prostate Cancer Aggressiveness and its Correlation to Gleason Score

Abstract

ancer prostate represents a major health problem. it is one of the most common solid malignancies among male population. DWI is a powerful clinical tool which provides information about tissue on a cellular level ADC maps derived DWI sequences has shown an increasing accuracy in addition to the DWI analysis in detection and localization of PCa. The ADC maps can provide quantitative measurements of tissue water diffusivity through ADC values which can be used for many applications including assessment of prostate cancer aggressiveness. Pathological Gleason score (GS) is a useful parameter for predicting prostate cancer aggressiveness, with a higher GS indicating increased biological aggressiveness. In conclusion, ADC values showed a inverse correlation with GS. This study suggests that ADC values may allow the noninvasive assessment of biological aggressiveness of prostate cancer, which may contribute in targeting biopsy to MRI-positive foci using a fusion of MRI and transrectal ultrasound. Incorporating the GS on targeted biopsy with the ADC value will further improve the detection of high-grade cancer foci also plays a role in planning initial treatment strategies.