JRM
Journal of Radiology in Medicine

Journal of Radiology in Medicine is an international journal that published original research and articles in all areas of radiology. Its publishes original research articles, review articles, case reports, editorial commentaries, letters to the editor, educational articles, and conference/meeting announcements.

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The role of ADC value and ADC ratio in the diagnosis and prognostic evaluation of prostate cancer
Abstract
Prostate cancer is the second most common malignancy in men after lung cancer and remains a major cause of cancer-related mortality. Although prostate-specific antigen testing has reduced mortality, its low specificity leads to overdiagnosis and unnecessary biopsies. Multiparametric magnetic resonance imaging has advanced prostate cancer evaluation by integrating anatomical, functional, and vascular imaging. Diffusion-weighted imaging and apparent diffusion coefficient measurements provide objective markers of tumor cellularity, which correlate with Gleason score and International Society of Urological Pathology Grade Group. To summarize the diagnostic and prognostic role of absolute apparent diffusion coefficient values and the apparent diffusion coefficient ratio in prostate cancer. A narrative review of the literature from 2006 to 2025 was conducted through PubMed and Scopus using terms related to prostate cancer, diffusion-weighted imaging, apparent diffusion coefficient, ratio, and prostate-specific antigen density. Twenty-seven references were included, ranging from early technical reports to recent meta-analyses and guideline-based studies. Absolute apparent diffusion coefficient values decrease with increasing tumor aggressiveness but are limited by technical and patient-related variability. The apparent diffusion coefficient ratio, calculated as the lesion value relative to normal prostate tissue, reduces variability and improves diagnostic accuracy, particularly in Prostate Imaging Reporting and Data System category 3 lesions. When combined with prostate-specific antigen density, it increases accuracy for detecting clinically significant cancer and decreases unnecessary biopsies. Apparent diffusion coefficient and the apparent diffusion coefficient ratio are promising non-invasive imaging biomarkers that improve lesion characterization, biopsy selection, and prognostic evaluation in prostate cancer. Future integration with artificial intelligence, radiomics, and radiogenomics may enhance personalized patient management.

Keywords : Prostatic neoplasms, diffusion magnetic resonance imaging, apparent diffusion coefficient

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Article available in :
Volume 3, Issue 1, 2026
Page : 22-27
https://doi.org/10.51271/JRM-0045
Article Information
Received : 31 Ağu 2025
Accepted : 22 Eki 2025
Published : 09 Mar 2026
Corresponding Author :

Abdullah Enes Berksoy: Department of Radiology, Göksun State Hospital, Kahramanmaraş, Turkiye

[email protected]
Citation : Berksoy AE, Karacaoğlu MC. The role of ADC value and ADC ratio in the diagnosis and prognostic evaluation of prostate cancer. J Radiol Med. 2026;3(1):22-27.

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