BACKGROUND: In @entity3457 ( @entity3457 ) for @entity263 there are few data on long-term outcomes associated with novel imaging markers. OBJECTIVE: To determine long-term outcomes with respect to the apparent diffusion coefficient (ADC) derived from diffusion-weighted magnetic resonance imaging (DW-MRI) in a prospective @entity3457 cohort. Early results have already been published; we now present findings with long-term follow-up. DESIGN, SETTING, AND @entity1 : A subset of @entity1 (n=86) underwent pre-enrolment DW-MRI in a prospective @entity3457 study between 2002 and 2006. Inclusion criteria were @entity263 , clinical T1/T2a/N0M0, Gleason  <= 3+4, and prostate-specific antigen (PSA) <15 ng/ml. Protocol follow-up was by biopsy at 18-24 mo and then every 24 mo, with regular PSA measurement. INTERVENTION: @entity1 underwent baseline DW-MRI in addition to standard sequences. ADC was measured from the index lesion on T2-weighted images. To avoid influencing treatment decisions, DW-MRI sequence results were not available to the @entity3457 study investigators. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Baseline ADC was analysed with respect to time to radical treatment (TRT) and time to adverse histology (TAH). Kaplan-Meier analysis and univariate and multivariate regression analyses were performed. RESULTS AND LIMITATIONS: The median follow-up was 9.5 yr (interquartile range 7.9-10.0 yr). On univariate analysis, ADC below the median was associated with shorter TAH (hazard ratio [HR] 2.13, 95% confidence interval [CI] 1.17-3.89; p<0.014) and TRT (HR 2.54, 95% CI 1.49-4.32; p<0.001). Median TRT was 9.3 yr (95% CI 7.0-11.6 yr) for @entity1 with ADC above the median and only 2.4 yr (95% CI 1.5-6.0 yr) for ADC below the median. For TRT, addition of ADC to a multivariate model of baseline variables resulted in a significant improvement in model fit (HR 1.33, 95% CI 1.14-1.54; p<0.001). Receiver operating characteristic analysis for TRT revealed an area under the curve of 0.80 (95% CI 0.70-0.88). The number of variables included in the multivariate model was limited by sample size. CONCLUSIONS: Long-term follow-up for this study provides strong evidence that ADC is a useful marker when selecting @entity1 for @entity3457 . Routine DW-MRI is now being evaluated in our ongoing @entity3457 study for initial assessment and as an alternative to repeat biopsy. @entity1 SUMMARY: Before entering a study of close monitoring for the initial management of @entity263 , @entity1 had a type of magnetic resonance imaging scan that looks at the movement of water within @entity5 . These scans may help in predicting whether @entity1 should receive close monitoring or whether immediate treatment should be given.

Nine-year Follow-up for a Study of Diffusion-weighted Magnetic Resonance Imaging in a Prospective XXXX Active Surveillance Cohort.

@entity1 :: ('9606', 'Species') :: ['patients', 'Men', 'PARTICIPANTS', 'PATIENT'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancers'] @entity263 :: ('MESH:D011471', 'Disease') :: ['prostate cancer', 'untreated prostate cancer'] @entity3457 :: ('OMIM:612348', 'Disease') :: ['active surveillance', 'AS']
@entity263 :: (MESH:D011471,Disease) :: ['Prostate Cancer']
