The effectiveness of multiparametric prostate MRİ in diagnosis with clinical prostate CA suspicion

The aim of this study was to investigate the efficacy of the prostate imaging reporting and data system (PI-RADS) of guide in our patient population. Between January 2016 and March 2019, patients with positive examination and laboratory findings in favor of prostate cancer were included in the study. Cases with prostate biopsy indication (n: 52) were evaluated with 3T Magnetic Resonance Imaging (MRI) before biopsy. PIRADS scores were used in all cases and these scores were compared with histopathological results. Histopathological examination was accepted as the gold standard test. As a result of this comparison, sensitivity, specificity, positive predictive and negative predictive values of Multiparametric MRI were calculated. The mean age of the patients was 65.1 and the mean prostate specific antigen (PSA) values were 12,31 ng / ml (3,35-100). One of the 52 patients was PIRADS 1,9 patients PIRADS 2,15 PIRADS 3 patients, 13 patients PIRADS 4 and 14 patients was PIRADS 5. In pathological examination, 28 patients were reported as adenocarcinoma, 3 patients were reported as ASAP (Atypical Small Acinar Proliferation), 9 were benign prostate tissue (BPH), 8 were chronic prostatitis, and 4 patients were reported as others (chronic active prostatitis-inflammatory reaction). In comparison of these scores and histopathological accuracy, sensitivity, specificity and negative and positive predictive values were calculated as % 67.8 % 66.6, %64 and %70, respectively. Apparent diffusion coefficienty (ADC) measurements were made from the lesion areas of all patients. The mean ADC value of PIRADS 4-5 lesions were 0,53 x10-3 mm2, and the average ADC value of PIRADS 1-2-3 lesions were 1,26 x10-3 mm2/s. ADC values were significantly lower in the maligned quadrants than the benign quadrants (p <0,001). Keywords: PIRADS v2, multiparametric magnetic resonance imaging, prostate cancer