{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T17:29:36Z","timestamp":1790443776546,"version":"4.1.0"},"reference-count":23,"publisher":"Scientific Scholar","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2021,10]]},"abstract":"\n Background:<\/jats:title>\n \n Gallium-68-prostate-specific membrane antigen (\n 68<\/jats:sup>\n Ga-PSMA) positron emission tomography\/computed tomography (PET\/CT) has recently been shown to be very high accuracy in biopsy-na\u00efve prostate cancer (PCa) detection and can potentially improve the low specificity noted with diffusion-weighted magnetic resonance imaging (DW-MRI), especially in instances of prostate inflammation. We aimed to compare the diagnostic accuracy of DW-MRI and PSMA PET\/CT using apparent diffusion coefficient (ADC) and maximum standardized uptake (SUV\n max<\/jats:sub>\n ) values in the diagnosis of PCa.\n <\/jats:p>\n <\/jats:sec>\n \n Patients and Methods:<\/jats:title>\n \n A retrospective study comparing and analyzing the diagnostic accuracy of prebiopsy DW-MRI and\n 68<\/jats:sup>\n Ga-PSMA PET\/CTs done in patients with suspected PCa (raised prostate specific antigen [PSA] and\/or positive digital rectal examination) from January 2019 to December 2020. The standard of reference was transrectal ultrasound-guided biopsies.\n <\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n \n Sixty-seven patients were included in the study, mean age: 70 years (range 49\u201384), mean PSA: 23.2 ng\/ml (range 2.97\u201345.6). Biopsy was positive for PCa in 56% (\n n<\/jats:italic>\n = 38) and negative in 43% (\n n<\/jats:italic>\n = 29). Of the benign results, benign hyperplasia was noted in 75% (\n n<\/jats:italic>\n = 22) and prostatitis in 25% (\n n<\/jats:italic>\n = 7). Of the PCa, 55% (\n n<\/jats:italic>\n = 21) of were high International Society of Urological Pathology (ISUP) grade (4\u20135) and 45% (\n n<\/jats:italic>\n = 17) low\/intermediate ISUP grade (1\u20133). Overall the sensitivity\/specificity\/Accuracy for prediction of PCa of MRI using prostate imaging and reporting data system version 2 criteria and PSMA PET\/CT using PCa molecular imaging standardized evaluation criteria was 92.1%\/65.5%\/80.5% and 76.3%\/96.5%\/85.1% respectively. Mean apparent diffusion co-efficient (mean ADC) value of benign lesions and PCa was 1.135 \u00d7 10\n -3<\/jats:sup>\n mm\n 2<\/jats:sup>\n \/s and 0.723 \u00d7 10\n -3<\/jats:sup>\n mm\n 2<\/jats:sup>\n \/s, respectively (\n P<\/jats:italic>\n = 0.00001). Mean SUV\n max<\/jats:sub>\n and ADC of benign and PCa lesions was 4.01 and 16.4 (\n P<\/jats:italic>\n = 0.000246). Mean SUV\n max<\/jats:sub>\n \/ADC ratio of benign and malignant lesions was 3.8 \u00d7 103 versus 25.21 \u00d7 103 (\n P<\/jats:italic>\n < 0.000026). Inverse correlation was noted between ADC and SUV\n max<\/jats:sub>\n values (\n R<\/jats:italic>\n = \u22120.609), inverse correlation noted between ADC and Gleason's score (\n R<\/jats:italic>\n = \u22120.198), and positive correlation of SUV\n max<\/jats:sub>\n and SUV\n max<\/jats:sub>\n \/ADC with Gleason's score (\n R<\/jats:italic>\n = 0.438 and\n R<\/jats:italic>\n = 0.448). Receiver operating characteristic curve analysis revealed a SUV\n max<\/jats:sub>\n cutoff 6.03 (sensitivity\/specificity - 76%\/90%, area under the curve (AUC) - 0.935, Youden index (YI) - 0.66), ADC cutoff of 0.817 \u00d7 10\n \u22123<\/jats:sup>\n mm\n 2<\/jats:sup>\n \/s (sensitivity\/specificity \u2013 79%\/86%, AUC \u2013 0.890, YI - 0.65), and SUV\n max<\/jats:sub>\n \/ADC ratio cutoff of 7.43 \u00d7 103 (sensitivity\/specificity \u2013 87%\/98%, AUC - 0.966, YI - 0.85) for PCa diagnosis.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n \n For diagnosis of biopsy-na\u00efve PCas, the combination of diffusion-weighted MRI and PSMA PET\/CT (i.e., SUV\n max<\/jats:sub>\n \/ADC ratio) shows better diagnostic accuracy than either used alone and the combination of PET and MRI is especially useful when distinguishing cancer from prostatitis.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijnm.ijnm_62_21","type":"journal-article","created":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T11:06:36Z","timestamp":1639566396000},"page":"377-384","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":9,"title":["SUVmax\/ADC Ratio as a Molecular Imaging Biomarker for Diagnosis of Biopsy-Na\u00efve Primary Prostate Cancer"],"prefix":"10.25259","volume":"36","author":[{"given":"Sheela","family":"Chinnappan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piyush","family":"Chandra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John Santa","family":"Kumar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ganesan","family":"Chandran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satish","family":"Nath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","reference":[{"key":"R1-4-20240902","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/S1470-2045(18)30569-2","article-title":"MRI-FIRST investigators. 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