Prostate carcinoma: Accuracy of diagnosis and differentiation with Dynamic Contrast-Enhanced MRI and Diffusion Weighted Imaging

Abstract

Background: Diffusion weighted image (DWI) and dynamic contrast enhanced MR imaging (DCE-MRI) provide excellent parameters that are useful for differentiating cancer from normal tissue in prostatic cancer patients. Purpose: To define the diagnostic value of diffusion weighted image (DWI) and dynamic contrast enhanced MR imaging (DCE-MRI) and determine whether the combination of the two techniques provides higher diagnostic accuracy for prostate cancer than each technique alone. Material and methods: 30 patients suggested to have prostate cancer based on high PSA value underwent MRI examination including axial T2-WI, diffusion weighted image (DWI), apparent diffusion coefficient (ADC) and dynamic contrast enhanced MRI (DCE-MRI). The final diagnosis was confirmed by histopathological study of the TRUS-guided biopsies. Results: The sensitivity of DCE-MRI, ADC at 1.2 and ADC at 1.4 in detection of prostatic carcinoma was 100%, 84.6% and 100% respectively (P = 0.000). The highest validity for cancer prostate is DCE-MRI (Kappa = 0.93) followed by ADC at 1.4 (Kappa = 0.86) then ADC at 1.2 (Kappa = 0.79). Conclusions: DCE-MRI and DWI have high sensitivity to differentiate cancerous from non-cancerous prostatic tissue, and the combination of both techniques increase the diagnostic accuracy of prostatic cancer than each one alone.

Keywords

• Cancer prostate
• DCE-MRI
• DWI