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Efficacy of the apparent diffusion coefficient value for predicting biochemical recurrence in patients with high-risk prostate cancer
Apparent diffusion coefficient value가 가지는 고위험군 전립선암 환자의 생화학적 재발에 대한 예측능

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Authors
윤민영
Advisor
곽 철
Major
의과대학 의학과
Issue Date
2016-02
Publisher
서울대학교 대학원
Keywords
MRI DWI ADCprostate cancerhigh riskprognosisBCR free survival rate
Description
학위논문 (석사)-- 서울대학교 대학원 : 의학과 비뇨기과학 전공, 2016. 2. 곽철.
Abstract
Abstract
Efficacy of the apparent diffusion coefficient value for predicting biochemical recurrence in patients with high-risk prostate cancer

Yoon Min Young
Student Number : 2014-21130
Urology, College of medicine, Seoul National University

Introduction
The purpose of this study was to investigate whether the apparent diffusion coefficient (ADC) value in diffusion-weighted magnetic resonance imaging (DW-MRI) could predict the prognoses of patients with high-risk prostate cancer.

Materials and methods
The retrospective study included 157 patients with high-risk prostate cancer according to Damicos criteria. Patients underwent a preoperative 3-T MRI and a prostatectomy within 2 months. Patients who received neoadjuvant hormone therapy or radiation therapy were excluded. The apparent diffusion coefficient (ADC) of the tumor calculated from two b values (0, 1000 s/mm2) was measured. Areas under receiver-operating characteristics curves (AUC) were calculated to maximized the accuracy of ADC value. The cut-off point was 764 ×10-6 mm2/sec. Then, the patients were stratified into two groups: Group A consisted of patients with ADC values < 764×10-6 mm2/sec and Group B was ≥ 764×10-6 mm2/sec. Clinical and pathological outcomes were compared. The relation between the ADCmean and the BCR free survival rate were assessed by Kaplan-Meier Estimates. The Cox-proportional regression analyses were also performed.

Results
Group A showed higher pathologic stage and biochemical recurrence (BCR) rates than Group B. On the Kaplan-Meier estimates, the BCR-free survival rate of Group A was much lower than that of Group B. In Cox-proportional regression analyses, ADCmean <764×10-6 mm2/sec and pathologic stage ≥T3 disease were independent predictors of BCR, whereas mean age, PSA level, pathologic Gleason score ≥8, and positive surgical margin were not significantly correlated with BCR.

Conclusion
In patients with high-risk prostate cancer, ADCmean is significantly associated with BCR-free survival. ADC value is one of the useful tools to predict the prognoses of patients with high-risk prostate cancer.

Key words
MRI DWI ADC, prostate cancer, high risk, prognosis, BCR free survival rate
Language
English
URI
https://hdl.handle.net/10371/132869
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College of Medicine/School of Medicine (의과대학/대학원)Dept. of Medicine (의학과)Theses (Master's Degree_의학과)
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