Diffusion weighted MRI helps evaluate angiogenesis and vascular endothelial growth factor expression in prostate cancer

OBJECTIVE To study whether diffusion weighted imaging (DWI) and apparent diffusion coefficient (ADC) can reflect angiogenesis and the expression of the vascular endothelial growth factor (VEGF) by analyzing the correlation between the features of DWI and angiogenesis in prostate cancer (PCa). METHODS We studied the clinical and pathological data of 38 patients with histologically proven PCa, who were examined in the supine position with a 1.5T superconductive magnetic scanner (Siemens Sonata) with a pelvic phased array multi-coil. DWI was obtained by echo planar imaging (EPI) sequence. Another 33 cases of benign prostate hyperplasia (BPH) and 15 healthy volunteers were detected for the ADC value in the PCa and BPH tissues and the peripheral zone (PZ). All the PCa samples were examined for microvascular density (MVD) and VEGF. RESULTS The ADC values of PCa, BPH and PZ were (49.32 +/- 12.68) x 10(-5) mm2/s, (86.73 +/- 26.75) x 10(-5) mm2/s and (126.25 +/- 27.21) x 10(-5) mm2/s, the former lower than the latter two (P < 0.05). The expressions of MVD and VEGF in PCa were higher than in BPH (P < 0.05). The correlation was negative between the ADC value and MVD of PCa (r = -0.510, P < 0.05) , and positive between the expressions of VEGF and MVD (r = 0.481, P < 0.05). The ADC values of the VEGF-positive and -negative groups were (47.27 +/- 9.55) x 10(-5) mm2/s and (55.06 +/- 11.6) x 10(-5) mm2/s (P < 0.05). CONCLUSION The ADC value reflects the angiogenesis in differentiated prostate cancer, and DWI therefore helps to evaluate the biological features of PCa in vivo.