Comprehensive diagnostic model of metastasis in prostate cancer: Individual and combined bioscore model of ADC value, Gleason score, and PSA
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Date
2024
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Wiley
Abstract
Prostate cancer (PCa) metastasis significantly influences treatment decisions and progno sis. This study evaluated the individual and combined diagnostic ability of apparent diffu sion coefficient (ADC), Gleason score and prostate-specific antigen (PSA) in detecting
metastasis. The study included data from 120 biopsy-confirmed PCa patients treated
from 2019 to 2023. Whole-body MRI images, incorporating high-resolution T2 and axial
DWI sequences, were evaluated by experienced radiologists. Receiver operating charac teristic (ROC) curves and logistic regression models were used to assess the diagnostic
performance of ADC, Gleason score, and PSA in detecting metastasis. The prevalence of
PCa metastasis was 25.0%, with pelvic lymph node metastasis (16.7%) and bony metas tasis (12.5%) being most prevalent. Patients with PCa metastasis had significantly lower
ADC values, higher Gleason scores, and higher PSA levels compared to those without
metastasis. Individually, an ADC cut-off of ≤549.00 mm2
/s was the best marker for
detecting metastasis. The combined bioscore model including PSA, ADC values and
Gleason score was the best independent predictor, correlating with a 159-fold increased
likelihood of detecting PCa metastasis. This study demonstrated the prognostic ability of
PCa markers in detecting metastasis. ADC was an independent, sensitive, specific, and
accurate diagnostic marker. The combined bioscore model of ADC, PSA and Gleason
score significantly enhanced the identification of patients with PCa metastasis.
Description
This article is published by Wiley, 2024 and is also available at DOI: 10.1002/prm2.12140