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British Journal of Radiology (2008) 81, 456-462
© 2008 British Institute of Radiology
doi: 10.1259/bjr/29869950
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Full paper

Correlation of diffusion-weighted MRI with whole mount radical prostatectomy specimens

N VAN AS, MRCP, FRCR 1 E CHARLES-EDWARDS, MSc 2 A JACKSON, MRCP, FRCR 1 S JHAVAR, MD, DMB 3 S REINSBERG, PhD 4 N DESOUZA, FRCR, MD 5 D DEARNALEY, FRCR, MD 1 M BAILEY, FRCS 6 A THOMPSON, FRCS 7 T CHRISTMAS, FRCS 7 C FISHER, FRCPath 3 C CORBISHLEY, FRCPath 8 and S SOHAIB, MRCP, FRCR 2

1 Academic Unit of Radiotherapy and Oncology, 2 Department of Radiology and, 3 Section of Clinical Magnetic Resonance, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, Surrey, UK, 4 Department of Pathology, St George's Hospital NHS Trust, London, UK, 5 Department of Pathology, Royal Marsden NHS Foundation Trust and Institute of Cancer Research, Sutton, Surrey, UK, 6 Department of Urology, St George's Hospital NHS Trust, London, UK, 7 Department of Physics and Astronomy, University of British Columbia, Vancouver BC, Canada, 8 Department of Urology, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK

Correspondence: Dr N van As, Academic Unit of Radiotherapy and Oncology, Royal Marsden Hospital, Downs Road, Sutton, Surrey SM2 5PT, UK. E-mail: Nicholas.vanas{at}rmh.nhs.uk

The purpose of this study was to compare the apparent diffusion coefficient (ADC) of benign central gland (bCG), benign peripheral zone (bPZ) and cancer using diffusion-weighted MRI and whole mount specimens. 11 patients with biopsy-proven prostate cancer underwent diffusion-weighted MRI prior to radical prostatectomy. A single-shot echo planar image technique was used with b-values of 0 s mm–2, 300 s mm–2, 500 s mm–2 and 800 s mm–2. Whole mount specimens were compared with ADC maps. Areas of cancer, bCG and bPZ were identified, and regions of interest were drawn on ADC maps. Mean ADC values were recorded for all regions of interest, and paired t-tests were performed to compare mean values. Cancer was outlined in nine patients. In two patients, the tumours were too small to correlate with images; bCG was identified in 11 patients and bPZ was identified in 10 patients. Mean ADC values for bCG, bPZ and cancer were, 1.5x10–3mm2 s–1 (standard error (SE) = 0.04), 1.7x10–3mm2 s–1 (SE = 0.1), and 1.3x10–3mm2 s–1 (SE = 0.09), respectively. The most significant difference between benign tissue and cancer existed at b-values of 0–300 s mm–2 (bCG vs cancer: mean difference = 0. 29, p = 0.001, 95% confidence interval (CI) = 0.17–0.41; bPZ vs cancer: mean difference = 0.34, p = 0.003, 95% CI = 0.18–0.61)

In conclusion, we have confirmed, using whole mount verification, a significant difference in the ADC between benign tissue and cancer.




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