The Value of Apparent Diffusion Coefficient in Determining Gleason Score of Prostate Cancer

Abstract

Objective: Evaluate the correlation and value of apparent diffusion coefficient (ADC) in determining the Gleason score of prostate cancer (PC).
Methods: From January 2023 to December 2024, 39 patients were diagnosed and had histopathological results of PC, who had undergone prostate MRI before. We evaluated the correlation between the ADC
value and the Gleason score using Spearman’s correlation coefficient, then compared the ADC value between two groups of clinical insignificance (Gleason =6) and clinical significance PC (Gleason >6) by using Mann-Whitney U test. The ROC curve was used to find the ADC value in distinguishing clinical insignificance and significance PC.
Results: The average age of patients was 75.8 ± 7.3 years. The mean gland volume was 48.4 ± 25.4 grams. 62% of PC originated from the peripheral region, 38% originated from the central glandular region.
7.7% of patients had a Gleason score = 6, 92.3% of patients had a Gleason score > 6. The ADC value at the lesion was strongly negatively correlated with the Gleason score, with Spearman’s correlation coefficient = -0.619 (p = 0.000). The mean ADC value of the Gleason =6 group was 1194.33 ± 41.9 s/mm2, statistically higher than that of the Gleason >6 group at 802.3 ± 115.4 s/mm2 (p <0.05). ROC curve analysis showed that with an ADC threshold of 1093.5 s/mm2, diffusion MRI was able to differentiate clinically insignificant and significant PC with a sensitivity of 100% and a specificity of 97.2%.
Conclusion: ADC values were significantly correlated with Gleason scores and were able to predict clinically insignificant and significant PC.