Prostate tumor growth in patients on active surveillance: is a change in the apparent diffusion coefficient an indicator of an accelerated growth rate?
Veronica A Morgan1,2, Chris Parker3, and Nandita M deSouza1,2
1MRI, Royal Marsden Hospital, Sutton, United Kingdom, 2Clinical Magnetic Resonance Unit, Institute of Cancer Research, London, United Kingdom, 3Urology, Royal Marsden Hospital, Sutton, United Kingdom
We evaluated
relationship between tumor doubling time and ADC in prostate cancer patients managed
by active surveillance. Tumor (defined as a low signal-intensity T2-W region showing
restricted diffusion and a Type3 contrast-enhanced curve within a biopsy
positive octant) volume was calculated at 3 time-points ~12-24mths apart in 22 patients
by drawing regions-of-interest
on the T2-W images. Mean tumor ADC was estimated centrally through the tumor. Five
of 22 tumors (22.7%) showed growth acceleration after the second time-point. A 10% decrease in ADC identified 3 of 4
tumors and missed 1 of 22 cases with a doubling time of <12 months.
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