Correlation of MRI-Derived Apparent Diffusion Coefficient (ADC) Values With Gleason Scores in Prostate Cancer and Quantitative Prostate MRI Reading.
[BACKGROUND] Accurate characterization of prostate cancer (PCa) aggressiveness remains a clinical challenge.
- p-value p < 0.001
APA
Bird VY, Masihy K, et al. (2026). Correlation of MRI-Derived Apparent Diffusion Coefficient (ADC) Values With Gleason Scores in Prostate Cancer and Quantitative Prostate MRI Reading.. Cureus, 18(4), e106336. https://doi.org/10.7759/cureus.106336
MLA
Bird VY, et al.. "Correlation of MRI-Derived Apparent Diffusion Coefficient (ADC) Values With Gleason Scores in Prostate Cancer and Quantitative Prostate MRI Reading.." Cureus, vol. 18, no. 4, 2026, pp. e106336.
PMID
41993765
Abstract
[BACKGROUND] Accurate characterization of prostate cancer (PCa) aggressiveness remains a clinical challenge. While multiparametric MRI (mpMRI) and Prostate Imaging Reporting and Data System (PI-RADS) scoring are widely used, their qualitative nature introduces inter-reader variability. Apparent diffusion coefficient (ADC) values derived from diffusion-weighted imaging (DWI) may provide a more objective biomarker of tumor severity.
[METHODS] We retrospectively analyzed 181 lesions from 101 patients with biopsy-proven PCa (2019-2025). The lowest or minimum ADC (ADC) value (µm/s) was recorded for each lesion and correlated with Gleason scores: low-risk (3+3), intermediate-favorable (3+4), intermediate-unfavorable (4+3), and high-risk (≥4+4). Statistical analysis was performed using Welch's analysis of variance (ANOVA) with Games-Howell post hoc testing.
[RESULTS] Mean ADC values showed a progressive decline with increasing Gleason category: 3+3 = 456.5 ± 191 µm/s; 3+4 = 382.0 ± 188 µm/s; 4+3 = 296.2 ± 130 µm/s; ≥4+4 = 222.6 ± 134 µm/s. Interquartile ranges (IQRs) similarly decreased across categories. Welch's ANOVA demonstrated significant overall group differences (F(3, 84.78) = 18.95, p < 0.001). Games-Howell post hoc tests revealed significantly lower ADC values in 4+3 and ≥4+4 compared with 3+3 (p < 0.001) and in ≥4+4 compared with 3+4 (p < 0.001).
[CONCLUSION] MRI-derived ADC values inversely correlate with Gleason scores, suggesting their potential as a non-invasive biomarker for PCa aggressiveness. Incorporating ADC values into clinical workflows may enhance biopsy targeting, risk stratification, and treatment planning.
[METHODS] We retrospectively analyzed 181 lesions from 101 patients with biopsy-proven PCa (2019-2025). The lowest or minimum ADC (ADC) value (µm/s) was recorded for each lesion and correlated with Gleason scores: low-risk (3+3), intermediate-favorable (3+4), intermediate-unfavorable (4+3), and high-risk (≥4+4). Statistical analysis was performed using Welch's analysis of variance (ANOVA) with Games-Howell post hoc testing.
[RESULTS] Mean ADC values showed a progressive decline with increasing Gleason category: 3+3 = 456.5 ± 191 µm/s; 3+4 = 382.0 ± 188 µm/s; 4+3 = 296.2 ± 130 µm/s; ≥4+4 = 222.6 ± 134 µm/s. Interquartile ranges (IQRs) similarly decreased across categories. Welch's ANOVA demonstrated significant overall group differences (F(3, 84.78) = 18.95, p < 0.001). Games-Howell post hoc tests revealed significantly lower ADC values in 4+3 and ≥4+4 compared with 3+3 (p < 0.001) and in ≥4+4 compared with 3+4 (p < 0.001).
[CONCLUSION] MRI-derived ADC values inversely correlate with Gleason scores, suggesting their potential as a non-invasive biomarker for PCa aggressiveness. Incorporating ADC values into clinical workflows may enhance biopsy targeting, risk stratification, and treatment planning.