Related Experiment Video
Updated: Jan 7, 2026
A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
Published on: March 21, 2025
Preoperative loco-regional assessment of prostate carcinoma using multi-parametric MRI and prostate-specific membrane
Hira Lal1, Devesh Malik1, Anuradha Singh1
1Department of Radiology.
Objectives:
The objective of this study is to evaluate the efficacy of multi-parametric MRI (mpMRI) and prostate-specific membrane antigen (PSMA) PET-computed tomography (CT) in preoperative loco-regional assessment of prostate carcinoma, correlating findings with histopathology.
Materials And Methods:
This prospective observational study enrolled 44 men (mean age 67.5 years) with suspected localized prostate cancer. All participants underwent mpMRI and PSMA PET-CT scans prior to histopathological confirmation via transrectal ultrasound-guided biopsies or radical prostatectomy. Imaging results were analyzed for sensitivity, specificity, and agreement with histopathology using Cohen's Kappa statistic. Key parameters, such as Prostate Imaging Reporting and Data System (PI-RADS) scores (mpMRI) and maximum standardized uptake (SUVmax) values (PSMA PET-CT), were correlated with Gleason scores.
Results:
MpMRI exhibited a sensitivity of 95% and specificity of 50%, while PSMA PET-CT achieved 96.3% sensitivity and 57.1% specificity. MpMRI showed strong agreement with histopathology for tumor site localization (Kappa = 0.760), surpassing PSMA PET-CT (Kappa = 0.651). PSMA PET-CT identified metastases in 27.2% of cases, while mpMRI detected extra-prostatic extension in 50%. Higher PI-RADS scores and SUVmax values were associated with increased Gleason scores, indicating aggressive disease.
Conclusion:
Both mpMRI and PSMA PET-CT offer high sensitivity for prostate cancer detection. MpMRI is superior for local staging, while PSMA PET-CT excels in identifying distant metastases. Their combined application enhances diagnostic accuracy and supports improved preoperative risk stratification in prostate carcinoma management.
