Table of Contents
ISRN Radiology
Volume 2014, Article ID 263417, 7 pages
Research Article

Assessment of Apparent Diffusion Coefficient Values as Predictor of Aggressiveness in Peripheral Zone Prostate Cancer: Comparison with Gleason Score

1Department of Radiology, The Aga Khan University Hospital, P.O. Box 3500, Stadium Road, Karachi 74800, Pakistan
2Department of Medical Imaging, King Abdul Aziz Hospital, National Guards Health Affairs, P.O. Box 2477, Al-Ahsa 31982, Saudi Arabia
3Radiology Department, Sultan Qaboos University Hospital, P.O. Box 38, 123 AL-Khod, Oman
4Karachi X-Rays, U/S and CT Scan Centre, M. A. Jinnah Road, Karachi 296, Pakistan

Received 31 August 2013; Accepted 19 December 2013; Published 9 February 2014

Academic Editors: H. Akan and V. D. Souftas

Copyright © 2014 Shayan Sirat Maheen Anwar et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To determine association between apparent diffusion coefficient value on diffusion-weighted imaging and Gleason score in patients with prostate cancer. Methods. This retrospective case series was conducted at Radiology Department of Aga Khan University between June 2009 and June 2011. 28 patients with biopsy-proven prostate cancer were included who underwent ultrasound guided sextant prostate biopsy and MRI. MRI images were analyzed on diagnostic console and regions of interest were drawn. Data were entered and analyzed on SPSS 20.0. ADC values were compared with Gleason score using one-way ANOVA test. Results. In 28 patients, 168 quadrants were biopsied and 106 quadrants were positive for malignancy. 89 lesions with proven malignancy showed diffusion restriction. The mean ADC value for disease with a Gleason score of 6 was 935 mm2/s (  mm2/s); Gleason score of 7 was 837 mm2/s (  mm2/s); Gleason score of 8 was 614 mm2/s (  mm2/s); and Gleason score of 9 was 571 mm2/s (  mm2/s). Inverse relationship was observed between Gleason score and mean ADC values. Conclusion. DWI and specifically quantitative ADC values may help differentiate between low-risk (Gleason score, 6), intermediate-risk (Gleason score, 7), and high-risk (Gleason score 8 and 9) prostate cancers, indirectly determining the aggressiveness of the disease.