Comparison of magnetic resonance imaging findings and biopsy results in patients with positive physical examination and laboratory findings in favor of prostate cancer

Purpose: Our purpose in this study is to investigate the value of dynamic magnetic resonance imaging and also the multiparametric MRI (magnetic resonance imaging) that is acquired by adding diffusion weighted imaging to the dynamic contrast enhanced MR (magnetic resonance) images as noninvasive diagnostic tools for prostate cancer of which the diagnose is still based on digital rectal examination, laboratory and ultrasound findings and ultrasound-guided biopsy . Materials and Methods: Patients (n:40) having positive physical and laboratory findings in favor of prostate cancer and had indication for prostate biopsy who applied to Urology Department of Bülent Ecevit University Hospital in between March 2014 and January 2015 were informed about the study and T2 weighted, dynamic contrast enhanced T1 weigted and diffusion weighted MR images were acquired with a 4 phased array abdominal coil and subsequently 36 patients underwent 12/14 core transrectal ultrasound guided prostate biopsy. Retrospectively MRI findings and biopsy results were compared. Results: The mean age of the patients were 65,06 (± 6,04). The lesion detection capacities of the T2 weighted, dynamic contrast enhanced T1 weighted and diffusion weigted images were identified by detailing the sensitivity, specificity, predictive values and accuracy. The sensitivity, specificity, predictive values and accuracy of T2 weighted MRI were %100; %79,3; %53,8; %100 and 83,3 and all the parameters were %100 for DCE (dynamic contrast enhanced) T1 weighted MRI. The sensitivity, specificity, predictive values and accuracy of diffusion weighted imaging were lower relatively (%85,7; %40; %68,9; %95; %72). When the three were evaluted combined the sensitivity, specificity, predictive values and accuracy were found to be %100. Discussion: The advancements in MRI techniques are considered to be a serious potential for improving diagnostic accuracy of prostate cancer detection. Dynamic contrast enhanced MRI's use in prostate imaging is based on the estimation that tumour vascularity is fragile and has a structure that contrasts easily. Thus, for malignant tumours the enhancement pattern is expected to be early, rapid and strong enhancement and then rapid wash out in the malign portion of the tissue whereas healthy tissue's signal intensity rises slowly and continuously. It is reported that early (arterial) enhancement pattern and morphological criteria's use has a higher accuracy and less variability in between interpretations. More MRI studies show that dynamic enhanced MR images combined with diffusion weigted and MR spectroscopic images, especially acquired with high magnetic field machines (3T) will develop detecting and characterizing prostate cancer. DCE can be interpreted independently or combined with other sequences. Conclusion: Dynamic enhanced MRI has a high sensitivity for detecting prostate cancer and when combined with a functional parameter such as diffusion weighted imaging; sensitivity and specifity, also predictive values and accuracy will be strengthened.