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Diagnostic performance of apparent diffusion coefficient values in differentiating benign from malignant lesions in prostate PI-RADS v2.1 category 1 "nodules in nodule".

Abdominal radiology (New York) 2025 Vol.50(11) p. 5292-5304

Sun M, Li F, Zhang X, Wu R, Liu W, Xu L, Wu M, Wang Y

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[OBJECTIVES] To explore the associations between the apparent diffusion coefficient (ADC) values of prostate PI-RADS v2.1 category 1 "nodules in nodule" and their pathological characteristics.

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  • p-value p < 0.001
  • p-value p < 0.05

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BibTeX ↓ RIS ↓
APA Sun M, Li F, et al. (2025). Diagnostic performance of apparent diffusion coefficient values in differentiating benign from malignant lesions in prostate PI-RADS v2.1 category 1 "nodules in nodule".. Abdominal radiology (New York), 50(11), 5292-5304. https://doi.org/10.1007/s00261-025-04930-y
MLA Sun M, et al.. "Diagnostic performance of apparent diffusion coefficient values in differentiating benign from malignant lesions in prostate PI-RADS v2.1 category 1 "nodules in nodule".." Abdominal radiology (New York), vol. 50, no. 11, 2025, pp. 5292-5304.
PMID 40293519

Abstract

[OBJECTIVES] To explore the associations between the apparent diffusion coefficient (ADC) values of prostate PI-RADS v2.1 category 1 "nodules in nodule" and their pathological characteristics.

[METHODS] We retrospectively analyzed the prostate images from 226 male patients who underwent biopsy following MRI from January 2019 to December 2024. Two radiologists evaluated the PI-RADS v2.1 categories of identified nodules, measured the ADC values of the prostate nodules in a double-blind manner, and analyzed the associations between these values and the pathological characteristics of the nodules via independent sample t tests or Mann-Whitney U test.

[RESULTS] The ADC values of PI-RADS v2.1 category 1 "nodules in nodule" pathologically confirmed as clinically significant prostate cancer (csPCa) were lower than those of benign prostate hyperplasia (BPH) ((unit in ×10 mm/s)TZ: 0.739 ± 0.15 versus 0.984 ± 0.24; PZ: 0.719 ± 0.17 versus 1.036 ± 0.21, p < 0.001). The AUCs were 0.799 (TZ) with a cutoff of 0.835 × 10mm/s, and 0.873(PZ) with a cutoff of 0.795 × 10mm/s, respectively. The total prostate-specific antigen (tPSA), free/t PSA, PSA density (PSAD), and prostate gland volume (PGV) differed significantly between patients with PI-RADS v2.1 "nodules in nodule" that were pathologically confirmed as csPCa and patients with BPH (all p < 0.05).

[CONCLUSION] In patients with PI-RADS v2.1 category 1 "nodules in nodule", when the ADC values are less than 0.835 × 10mm/s in the TZ, the PI-RADS v2.1 score of the nodule can be upgraded to 3.

MeSH Terms

Retrospective Studies; Humans; Male; Prostatic Neoplasms; Diagnosis, Differential; Diffusion Magnetic Resonance Imaging; Middle Aged; Prostatic Hyperplasia; Prostate; Aged; Aged, 80 and over

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