Comparison between Gleason score and apparent diffusion coefficient obtained from diffusion-weighted imaging of prostate cancer patients.

OBJECTIVES: To correlate the apparent diffusion coefficient (ADC) of prostate cancer patients with pathological Gleason scores (GS). METHODS: 40 patients with GS 2 + 3, 3 + 3, 3 + 4, or 4 + 4 were selected. The magnetic resonance imaging (MRI) study was performed adding axial diffusion-weighted imaging (DWI) sequences to the standard MRI protocol. ADC values obtained were correlated with the GS data. RESULTS: Statistically significant differences of ADC (p < .05) were found among GS groups with a trend of decreasing ADC values with increasing GS. CONCLUSIONS: The ADC values may help clinicians to delineate prostate carcinoma, recognizing its high- or low-grade compartments.

Prostate cancer in magnetic resonance imaging: diagnostic utilities of spectroscopic sequences.

OBJECTIVE: The aim of our work is to determine the efficacy of a combined study 3 Tesla Magnetic Resonance Imaging (3T MRI), with phased-array coil, for the detection of prostate cancer using magnetic resonance spectroscopy (MRS) and diffusion-weighted images (DWI) in identifying doubt nodules. SUBJECTS AND METHODS: In this study, we prospectively studied 46 patients who consecutively underwent digital-rectal exploration for high doses of prostate specific antigen (PSA), as well as a MRI examination and a subsequent rectal biopsy. The study of magnetic resonance imaging was performed with a Philips Achieva 3T scanner and phased-array coil. The images were obtained with turbo spin-echo sequences T2-weighted images, T1-weighted before and after the administration of contrast medium, DWI sequences and 3D spectroscopic sequences. The ultrasound-guided prostate biopsy was performed approximately 15 days after the MRI. The data obtained from MR images and spectroscopy were correlated with histological data. RESULTS: MRI revealed sensitivity and specificity of 88% and 61% respectively and positive predictive value (PPV) of 73%, negative predicted value (NPV) of 81% and accuracy of 76%. In identifying the location of prostate cancer, the sensitivity of 3T MRS was 92%, with a specificity of 89%, PPV of 87%, NPV of 88% and accuracy of 87%; DWI showed a sensitivity of 88%, specificity of 61%, PPV of 73%, NPV of 81% and accuracy of 76%. CONCLUSIONS: The 3T MR study with phased-array coil and the use of DWI and spectroscopic sequences, in addition to T2-weighted sequences, revealed to be accurate in the diagnosis of prostate cancer and in the identification of nodules to be biopsied. It may be indicated as a resolute way before biopsy in patients with elevated PSA value and can be proposed in the staging and follow-up.