Objective value of the apparent diffusion coefficient (ADC) map from ultrahigh b-value diffusion-weighted imaging (DWI) in 3T MRI as a non-invasive predictor for Gleason score in prostate cancer

Q: What was the purpose of the study?

To assess whether ultrahigh b-value DWI-derived ADC values can predict the Gleason score of prostate cancer non-invasively.

Q: How was the ADC measured in the imaging protocol?

Patients underwent T2WI, conventional DWI, and ultrahigh b-value DWI, and ADC values were analyzed across different b-values using biopsy as the reference standard.

Q: Which b-value performed best for differentiating Gleason <7 vs ≥7 lesions?

b=3,000 s/mm² showed greater diagnostic accuracy than b=2,000 s/mm² based on ROC analysis.

Sep 22, 2026

Upload by Alex Sinclair

Accurate risk stratification of prostate cancer depends on obtaining reliable Gleason scores. This study evaluates whether ultrahigh b-value diffusion-weighted imaging (DWI) in 3T MRI can non-invasively predict Gleason score using quantitative apparent diffusion coefficient (ADC) measurements. Seventy-eight patients underwent T2WI, conventional DWI, and ultrahigh b-value DWI with b=2,000 and 3,000 s/mm², with biopsy as the reference standard. Ultrahigh b-values showed significant ADC separation between cancerous and noncancer tissues, strong inverse correlations with Gleason scores, improved ROC performance at b=3,000, and distinct ADC values for low- versus intermediate/high-risk groups.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Background

Methods

Imaging and ADC evaluation

Reference standard and statistical analysis

Results

Lesion-based ADC comparisons

Correlation with Gleason score

Risk stratification and ROC performance

Conclusions

Original Article Objective value of the apparent diffusion coefficient (ADC) map from ultrahigh b-value diffusion-weighted imaging (DWI) in 3T MRI as a non-invasive predictor for Gleason score in prostate cancer Kun Zhang1*, Zhengming Chen1\#, Chen Zhang1\#, Meifeng Wang1, Yonggui Fu1, Yun Zhang2, Yingying Hu2, Yanguang Shen3*, Huiyi Ye4* 1Department of Radiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, China; 2Department of Radiology, Peking University International Hospital, Beijing, China; 3Department of Radiology, Beijing University of Chinese Medicine Third Affiliated Hospital, Beijing, China; 4Department of Radiology, Chinese PLA General Hospital, Beijing, China Contributions: (I) Conception and design: K Zhang, Y Shen, H Ye; (II) Administrative support: K Zhang, Y Shen, H Ye; (III) Provision of study materials or patients: K Zhang, Z Chen, C Zhang, M Wang, Y Fu; (IV) Collection and assembly of data: K Zhang, Z Chen, C Zhang, Y Fu, Y Zhang, Y Hu; (V) Data analysis and interpretation: K Zhang, Z Chen, C Zhang, M Wang, Y Fu; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. \#These authors contributed equally to this work as co-first authors. *These authors contributed equally to this work. Correspondence to: Kun Zhang, MD. Department of Radiology, The Sixth Medical Center of Chinese PLA General Hospital, 6 Fucheng Rd, Haidian District, Beijing 100048, China. Email: [zkbeir@163.com](zkbeir@163.com); Yanguang Shen, MD. Department of Radiology, Beijing University of Chinese Medicine Third Affiliated Hospital, 51 Anwai Xiaoguan St, Chaoyang District, Beijing 100080, China. Email: [shenyanguang@163.com](shenyanguang@163.com); Huiyi Ye, MD. Department of Radiology, Chinese PLA General Hospital, 28 Fuxing Rd, Haidian District, Beijing 100080, [China. Email: hyi_ye@163.com](China. Email: hyi_ye@163.com). Background: Accurate risk stratification of prostate cancer (PCa) is crucial for clinical management. Although diffusion-weighted imaging (DWI) is widely used in PCa evaluation, the value of high and ultrahigh b-values remains under investigation. This study aimed to explore the predictive value of ultrahigh b-value DWI for the Gleason score of PCa patients. Methods: This study gathered a total of 78 patients and acquired T2-weighted imaging (T2WI), conventional DWI (0, 1,000 s/mm2), and ultrahigh b-value DWI (0, 2,000, and 3,000 s/mm2) from each patient. Using reference biopsy as the gold standard, the apparent diffusion coefficient (ADC) of DWI images at different b-values was analyzed. On the basis of regression analysis at various b-values and receiver operating characteristic (ROC) curves, the 3,000 s/mm2 ultrahigh b-value DWI demonstrated greater diagnostic performance in assessing the differentiation of PCa. Results: A total of 154 biopsy-confirmed lesions (102 cancerous lesions and 52 noncancer lesions) were analyzed. Ultrahigh b-value DWI (b=2,000 and 3,000 s/mm2) demonstrated significant differences in ADC values between PCa and noncancerous tissues (P<0 .05): at b=2,000 s/mm2, the PCa ADC was 0. 740±0 .173 ×10−3 mm2/s vs. the non-PCa ADC was 0. 949±0 .176 ×10−3 mm2/s, whereas at b=3,000 s/mm2, the PCa ADC decreased to 0. 581±0 .130 vs. the non-PCa ADC was 0. 748±0 .179 ×10−3 mm2/s, with no overlap between groups. Both b-values showed inverse correlations between the ADC values and Gleason scores (b=2,000: r=−0 .401, R2=0 . 161; b=3,000: r=−0 .489, R2=0 .240), with stronger linearity at higher b-values. Risk stratification revealed distinct ADC values between the low-risk (0 .926±0 .125 ×10−3 mm2/s at b=2,000; 0. 726±0 .097 ×10−3 mm2/s at b=3,000) and intermediate/high-risk groups (P<0 .05), although no significant differences existed between the intermediate-and high-risk groups (P>0.05). ROC analysis for differentiating Gleason <7 vs. ≥7 lesions revealed greater diagnostic accuracy at b=3,000 [area under the curve (AUC) © A

FAQs

What was the purpose of the study?

To assess whether ultrahigh b-value DWI-derived ADC values can predict the Gleason score of prostate cancer non-invasively.

How was the ADC measured in the imaging protocol?

Patients underwent T2WI, conventional DWI, and ultrahigh b-value DWI, and ADC values were analyzed across different b-values using biopsy as the reference standard.

Which b-value performed best for differentiating Gleason <7 vs ≥7 lesions?

b=3,000 s/mm² showed greater diagnostic accuracy than b=2,000 s/mm² based on ROC analysis.

Sep 22, 2026

Upload by Alex Sinclair