%0 Journal Article
%T Association between mpMRI detected tumor apparent diffusion coefficient and 5-year biochemical recurrence risk after radical prostatectomy.
%A Alessi S
%A Maggioni R
%A Luzzago S
%A Summers PE
%A Renne G
%A Zugni F
%A Belmonte M
%A Raimondi S
%A Vignati S
%A Mistretta FA
%A Di Meglio L
%A D'Ascoli E
%A Scarabelli A
%A Marvaso G
%A De Cobelli O
%A Musi G
%A Jereczek-Fossa BA
%A Curigliano G
%A Petralia G
%J Radiol Med
%V 129
%N 9
%D 2024 Sep 16
%M 39014292
%F 6.313
%R 10.1007/s11547-024-01857-0
%X <B>OBJECTIVE: </B>To assess the ability of tumor apparent diffusion coefficient (ADC) values obtained from multiparametric magnetic resonance imaging (mpMRI) to predict the risk of 5-year biochemical recurrence (BCR) after radical prostatectomy (RP).<BR><B>METHODS: </B>This retrospective analysis included 1207 peripheral and 232 non-peripheral zone prostate cancer (PCa) patients who underwent mpMRI before RP (2012-2015), with the outcome of interest being 5-year BCR. ADC was evaluated as a continuous variable and as categories: low (< 850 µm2/s), intermediate (850-1100 µm2/s), and high (> 1100 µm2/s). Kaplan-Meier curves with log-rank testing of BCR-free survival, multivariable Cox proportional hazard regression models were formed to estimate the risk of BCR.<BR><B>RESULTS: </B>Among the 1439 males with median age 63 (± 7) years, the median follow-up was 59 months, and 306 (25%) patients experienced BCR. Peripheral zone PCa patients with BCR had lower tumor ADC values than those without BCR (874 versus 1025 µm2/s, p < 0.001). Five-year BCR-free survival rates were 52.3%, 74.4%, and 87% for patients in the low, intermediate, and high ADC value categories, respectively (p < 0.0001). Lower ADC was associated with BCR, both as continuously coded variable (HR: 5.35; p < 0.001) and as ADC categories (intermediate versus high ADC-HR: 1.56, p = 0.017; low vs. high ADC-HR; 2.36, p < 0.001). In the non-peripheral zone PCa patients, no association between ADC and BCR was observed.<BR><B>CONCLUSIONS: </B>Tumor ADC values and categories were found to be predictive of the 5-year BCR risk after RP in patients with peripheral zone PCa and may serve as a prognostic biomarker.