Sage Journals: Discover world-class research

Abstract

Objective: The aim of this study was to evaluate the role of diffusion-weighted imaging (DWI) and Apparent Diffusion Coefficient (ADC) MRI techniques in the detection and localization of prostate carcinoma in Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM). Materials and Methods: DWI ( $b$ value $=$ 800 s/mm ${}^{2})$ and ADC at 3T were evaluated retrospectively in 78 male patients with suspicion of prostate cancer. The prostate MRI was evaluated after dividing each prostate gland into 6 sections ( $n=$ 462). Six sections were excluded as biopsy result came back as unsatisfactory. Minimum ADC values of each section in the peripheral zone were measured. The MRI finding was compared with biopsy result obtained from each section. Results: The mean minimum ADC values of malignant sextants were significantly lower than that of noncancerous tissue, with a significant negative correlation between the ADC value and the Gleason score. The sensitivity and specificity for DWI $+$ ADC were 52.14% and 93.48% respectively. There is significant difference between malignant and benign ADC value ( $p=$ 0.0000). The area under the receiver operating characteristic curve for the detection and localization of prostate cancer within the peripheral zone is 0.788 for ADC, which represents a fair to good test. The cut off ADC value between benign and malignant tissue is 1174.5 mm ${}^{2}$ /s at 93.48% specificity. Conclusion: The current DWI and ADC technique used in our center is very specific and is valuable in detecting, localizing, grading prostate carcinoma and guiding targeted biopsy, with areas of lowest ADC values can indicate the regions to be biopsied.

Keywords

DWI MRI ADC prostate carcinoma

Get full access to this article

View all access options for this article.

References

Hoeks

C.M.

Barentsz

J.O.

Hambrock

, et al. Prostate cancer: Multiparametric Mr imaging for detection, localization, and staging, Radiology 261 (2011), 46–66.

Koh

D.M.

et al., Diffusion weighted MRI in the body: Applications and challenges in oncology, AJR 188 (2007), 1622–1635.

Sally

E.E.

Manal

Lamiaa

I.A.M.

and Rania

M.A.A.

, Diffusion-weighted MR imaging and ADC measurement in normal prostate, benign prostatic hyperplasia and prostate carcinoma, The Egyptian Journal of Radiology and Nuclear Medicine 45(2) (2014), 535–542.

Catalona

W.J.

Partin

A.W.

Slawin

K.M.

Brawer

M.K.

Flanigan

R.C.

Patel

Richie

J.P.

Dekernion

J.B.

Walsh

P.C.

Scardino

P.T.

Lange

P.H.

Subong

E.N.

Parson

R.E.

Gasior

G.H.

Loveland

K.G.

and Southwick

P.C.

, Use of the percentage of free prostatespecific antigen to enhance differentiation of prostate cancer from benign prostatic disease: A prospective multicenter clinical trial, J Am Med Assoc 279 (1998), 1542–1547.

Tchetgen

M.B.

and Oesterling

J.E.

, The effect of prostatitis, urinary retention, ejaculation, and ambulation on the serum prostate-specific antigen concentration, Urol Clin North Am 24 (1997), 283–291.

Mullerad

Hricak

Kuroiwa

Pucar

Chen

H.N.

Kattan

M.W.

and Scardino

P.T.

, Comparison of endorectal magnetic resonance imaging, guided prostate biopsy and digital rectal examination in the preoperative anatomical localization of prostate cancer, J Urol 174 (2005), 2158–2163.

Tan

Wei

Johnson

and Kundra

, Diffusion-weighted MRI in the detection of prostate cancer: Meta analysisCher, AJR 199 (2012) 822–829.

Noha

M.A.

Hytham

H.E.

and Essam

A.A.

, The role of diffusion – weighted MRI in evaluation of prostate cancer, The Egyptian Journal of Radiology and Nuclear Medicine 45(1) (2014), 231–236.

Ozgür

Tan

, Ercannci Arda

Sibel

Neslihan

and Nevzat

, Diffusion-weighted MRI of urinary bladder and prostate cancers, Diagn Interv Radiol 15 (2009), 104–110.

10.

Pietro

Davide

Antonio

, et al., Multiparametric MRI apparent diffusion coefficient (ADC) accuracy in diagnosing clinically significant prostate cancer, In Vivo 31(3) (2017), 415–418.

11.

Rajan

T.G.

Christopher

R.K.

Kirema

G.R.

et al., Apparent diffusion coefficient values of the benign central zone of the prostate: Comparison with low- and high grade prostate cancer, AJR 205(2) (2015), 331–336.

12.

Myung

S.C.

Yong

S.C.

Byung

I.Y.

J.K.

Hyuk

J.C.

Sung

H.H.

Y.L.

Tae-Kon

and Sae

W.K.

, The clinical value of performing an MRI before prostate biopsy, Korean J Urol 52(8) (2011), 572–577.

13.

KiM

C.K.

Park

B.K.

and Kim

, Diffusion-weighted MRI at 3T for the evaluation of prostate cancer, AJR 194 (2010), 1461–1469.

14.

Andrew

B.R.

, et al., Prostate cancer: Comparison of tumor visibility on trace diffusion-weighted images and the apparent diffusion coefficient map, AJR 196 (2011), 123–129.

Use of diffusion weighted imaging (DWI) MRI in localizing prostate carcinoma

Abstract

Keywords

Get full access to this article

References