Multiparametric MRI for the Diagnosis of Tumor Type in Patients Suspicious of Inner Gland Prostate Cancer

The current study aimed to evaluate multiparametric MRI for the diagnosis of type of tumor (benign ormalignant) in patients suspicious of inner gland prostate cancer.

This cross-sectional study was conducted on 44 consecutive patients with a clinicalimpression of prostate cancer who were referred to the MRI department of Payambaran Hospital, Tehran, Iranfor confirmative diagnostic evaluation. Cases suspected of tumor relapse and those who previously underwenttreatment for prostate cancer were excluded. Multiparametric MRI was performed for every patient by using a 1.5Tesla device with an integrated endorectal and pelvic-phased array coil. All patients subsequently underwent MRItransrectalultrasound fusion biopsy. The diagnostic value of each sequence was then investigated individually andin combination with other techniques by comparing the results with histological findings from MRI-TRUS fusionbiopsy.

Among the techniques, T2-weighted imaging (T2W) had the highest sensitivity and specificity whiledynamic contrast enhanced (DCE) technique had the least. Diffusion-weighted imaging (DWI) and magnetic resonancespectroscopy (MRS) had a similar sensitivity and specificity and did not significantly differ from T2W.Adding functional techniques to T2W did not improve diagnostic indices compared to T2W alone. Quantitativeevaluation of apparent diffusion coefficient (ADC), DWI, and MRS showed that all techniques were able to differentiatebetween benign and malignant tumors. However, the quantitative combination of these sequences decreaseddiagnostic performance.

T2W is the best technique for the diagnosis of type of tumor in terms of benignancy or malignancyin patients suspicious of inner gland prostate cancer. Adding functional imaging measurements to T2W does notimprove its diagnostic value.