Monoparametric prostate mri in the diagnosis of prostate cancer investigation of efficacy

Objective: The objective of this study was to assess the diagnostic efficacy of monoparametric magnetic resonance imaging (MRI) in prostate cancer and to determine the relationship between MRI findings and patient age, prostate volume, PSA value, PSA density and ADC value in radical prostatectomy patients with elevated postoperative Gleason score. Additionally, the study aimed to investigate the relationship between clinically significant cancer (CsCa) and PSA and PSA density, prostate volume, patient age and ADC value, and the relationship between PSA density and PIRADS score. Materials and Methods: A retrospective evaluation was conducted on 135 patients diagnosed with prostate cancer between 1 January 2020 and 1 October 2023. The evaluation was based on their magnetic resonance imaging (MRI) scans. Two observers performed the scoring using monoparametric MRI, which included diffusion-weighted imaging (DWI) and multiparametric MRI (mpMRI) images. In the postoperative pathological evaluation of the operated cases, the change in Gleason score was examined. The agreement between the observers, the efficiency of monoparametric MRI evaluation, and the relationship between ADC value, PSA value, PSA density, prostate volume, and age were analysed in CsCa cases and in cases with increased postoperative Gleason score. The relationship between PSA density and PIRADS was statistically calculated in patients with a PIRADS score of 3 and above and in patients with a high probability of malignancy. Results: A total of 135 patients with prostate cancer were retrospectively evaluated, and their MRIs were included in the study. The results demonstrated that the scores obtained from the monoparametric MRI and mpMRI evaluations exhibited a 93.33% similarity, with an excellent inter-observer agreement. The PSA value and PSA density were found to be significantly higher, while the ADC value was significantly lower, in patients with CsCa compared to those without CsCa. In patients with a PIRADS score of 3 or above, PSA density was found to increase in direct proportion to the PIRADS score. Conclusion: The findings of our study indicate that monoparametric MRI can detect malignancy at rates comparable to those observed with mpMRI. The study demonstrated that PSA density and PSA levels were significantly elevated, while the ADC value was significantly reduced, and that PSA density increased with an increasing PIRADS score in patients with CsCa.