Comparison of 3 tesla multiparametric prostate magnetic resonance imaging findings and histopathological findings in the diagnosis of prostate cancer

Aim: Our purpose was to evaluate the diagnostic performance of 3 Tesla multiparametric MR imaging in prostate cancer detection by using histopathological findings as the reference standard, and to determine the potential utility of MpMR imaging for identification of clinically significant prostate cancer. Materials and Methods: Between July 2017 and February 2018, 62 patients who were planned to undergo biopsy by Urology Department due to prostate cancer suspicion were included in the study. This patients who underwent 3 Tesla prostate MRI, were evaluated according to Prostate Imaging Reporting and Data System Versiyon 2 guidelines. All patients were scored by two radiologists blinded to pathology results, and then the correlation between PIRADSv2 scores and pathology results of 62 patients who had biopsy were analyzed. Findings: The mean age, PSA level and prostate volume of all patients were 65,6 years (46-86), 70,81 (3.11-1170) ng/ml, 52,22 (7,9-161,7 )ml, respectively. A statistically significant difference was found between PIRADS score of T2 weighted (T2W), diffusion weighted imaging (DWI), dynamic contrast enhanced imaging (DCE), multiparametric magnetic resonance imaging (MpMRI) and histopathological results (p<0,05). For T2W, the sensitivity was %83,87, the specifity was %61,29 (criteration>PIRADS 3, area under curve;0,73), for DWI the sensitivity was %93,55, the specifity was %80,65 (criteration > PIRADS 3, area under curve;0,87), for DCE the sensitivity was %93,55, the specifity was %67,74 (criteration for positive enhancement, area under curve;0,81). For MpMRI the sensitivity was %96,77, the specifity was %74,19 (criteration > PIRADS 3, area under curve;0,85). The ADC cut off value was found 0,7 x 10−3 mm2/sec. ROC analysis was found for this cut off value area under curve;0,943, the sensitivity was %93,5, the specifity %83,9. Conclusion: MpMRG appears to be very promising in identifying patients with suspected prostate cancer, localizing, characterizing, determining the level of risk, and determining patient selection and observation strategies for biopsy according to risk level. Key words:Prostate Cancer, Multiparametric Magnetic Resonance Imaging (MpMRG), TRUS Biopsy, Clinically Significant Prostate Cancer