Cellular density of low-grade transition zone prostate cancer: A limiting factor to correlate restricted diffusion with tumor aggressiveness. Issue 131 (October 2020)

• Record Type: Journal Article
• Authors: Barral, Matthias; Jemal-Turki, Aida; Beuvon, Frédéric; Soyer, Philippe; Camparo, Philippe; Cornud, François
• Is Part Of: European journal of radiology. Issue 131(2020)
• Publication Date: 2020-10
• Subjects: bp-MRI biparametric MRI -- GS Gleason score -- MRI magnetic resonance imaging -- mp-MRI multiparametric MRI -- PPA pelvic-phased-array -- PCa prostate cancer -- ROI region of interest -- SD standard deviation -- TZ-PCa transition zone prostate cancer -- PZ-PCa peripheral zone prostate cancer; Prostate neoplasm -- MRI -- Neoplasm grading -- Diffusion magnetic resonance imaging -- Correlation of data; Medical radiology -- Periodicals; Radiology -- Periodicals; Radiologie médicale -- Périodiques; Medical radiology; Periodicals; 616.075705
• DOI: 10.1016/j.ejrad.2020.109230
• Languages: English
• ISSNs: 0720-048X

Abstract

Highlights: The mean ADC (ADCmean) of Gleason score (GS) 3 + 3 transitional zone prostate cancer (TZ-PCa) is lower than that of peripheral zone prostate cancer (PZ-PCa). ADCmean of GS 3 + 3 TZ-PCa is similar to that of high-grade PCa of any zone. In patients with GS 3 + 3 PCa, TZ-PCa shows higher glandular density than PZ-PCa. Poor correlation exists between glandular density (ADCmean) and glandular differentiation (GS). Abstract: Objective: To compare the mean apparent diffusion coefficient (ADCmean) and glandular density of Gleason score (GS) 3 + 3 transition zone prostate cancers (TZ-PCa) with those of the peripheral zone (PZ-PCa). Material & methods: Seventy-nine men (mean age: 65 ± 6 [SD] years; range: 52–81 years) with 37 TZ-PCa (37/79; 53 %) and 42 PZ-PCa (42/79; 47 %) had prostate MRI before radical prostatectomy. Glandular cell density was semi-quantitatively evaluated in all tumors. ADCmean and glandular cell density of GS3 + 3 TZ-PCa were compared to those of PZ-PCa. ADCmean was correlated to GS in each zone. Results: ADCmean of GS 3 + 3 tumors was significantly lower in the TZ (728 × 10 −6 ±52 [SD] mm²/s; range: 670−1060mm²/s) than in the PZ (865 × 10 −6 ±121 [SD] mm²/s; range: 670−1120mm²/s) (p = 0.0007), related to a significantly higher glandular density involving more than 50 % of the tumor in 58 % (7/12) of patients in GS3 + 3 TZ-PCa versus 7.6 % (1/13) in PZ-PCa (p = 0.03). ADCmean of GS3 + 3 TZ-PCa was not significantly different from that of GS 3 + 4 (p = 0.14) or GS>3 + 4 Ca (p = 0.9), whatever the zone of origin. In the PZ, ADCmean of GS 3 + 3-PCa was higher than that of Gleason>3 + 4 PZ-PCa (p = 0.02) and similar to that of GS 3 + 4 PZ-PCa (p = 0.24). Correlation between ADCmean and GS was weak for TZ-PCa (ρ = 0.32; p = 0.04) and moderate for PZ-PCa (ρ = 0.45; p = 0.003). Conclusion: ADCmean of GS 3 + 3 TZ-PCa is significantly lower than that of GS 3 + 3 PZ-PCa, related to a unique dense histological pattern and reaches that of higher-grade PCa, whatever the zone of origin.