Importance of diffusion-weighted MRI and dynamic contrast-enhanced MRI in the diagnosis of prostate cancer

The aim of this study is to investigate the contribution of diffusion-weighted magnetic resonance imaging (DWMRI) in the differentiation of pathological malignant and benign prostate lesions which were detected in patients screened for suspected prostate cancer by pelvic abdomen dynamic contrast-enhanced MRI and DWMRI.A total 50 patients aged between 50-85 years old who were suspected for prostate cancer and screened by pelvic MRI between January 2009 and January 2010 at Department of Radiology department included in our study. Eleven of these patients having diagnosis of normal prostate tissue were control group. The ADC values of patients were measured with diffusion-weighted EPI imaging at b100, b600, b1000 gradients values, respectively.Cytological examination transrectal ultrasonographic (TRUS) specimens biopsy results cytologically showed normal prostate tissue in 11 patients, prostatitis in 9 patients and adenocarcinoma in 20 patients. Histopathological results in 10 patients who underwent radical prostatectomies were diagnosed as adenocarcinoma.ADC values of the tissues reported cytologically and histologically as prostate cancer and normal tissue and prostatitis by surgery and biopsy were compared.ADC values measured in 30 patients with prostate cancer (b100, b600, b1000), (2.06x10-3; 1.57x10-3; 1.35x10-3 mm2/sec, respectively) were statistically significantly lower than ADC values measured in patients with normal prostate tissues (b100, b600, b1000), (2.43x10-3; 1.77x10-3; 1.47x10-3 mm2/sec, at b100, b600, b1000 gradients respectively), and these were statistically significant (p=0.001). ADC values measured in patients with prostatitis (b100, b600, b1000), (2.25x10-3; 1.69x10-3; 1.48x10-3 mm2/sec) were found higher than ADC values measured in patients with prostate cancer, and the difference was statistically significant (p=0.02). The difference between ADC values measured in patients with prostatitis and normal prostate tissue was not found statistically significant (p=0.919).As a result: diffusion MRI with measurement of ADC values as a functional imaging method may provide an important role for differentiation prostate cancer from normal prostate tissue and prostatitis.Keywords: Magnetic resonance imaging (MRG), prostate cancer, ADC, difussion weighted ımaging (DWI).