Prostate cancer screening: the clinical value of diffusion-weighted imaging and dynamic MR imaging in combination with T2-weighted imaging.
OBJECTIVE
To evaluate the clinical value of diffusion-weighted imaging (DWI) and dynamic MRI in combination with T2-weighted imaging (T2W) for the detection of prostate cancer.


METHODS
A total of 83 patients with elevated serum prostate specific antigen (PSA) levels (>4.0 ng/mL) were evaluated by T2W, DWI, and dynamic MRI at 1.5 T prior to needle biopsy. The data from the results of the T2W alone (protocol A), combination of T2W and DWI (protocol B), and the combination of T2W+DWI and dynamic MRI (protocol C) were entered into a receiver operating characteristic (ROC) curve analysis, under results of systemic biopsy as the standard of reference.


RESULTS
Prostate cancer was pathologically detected in 44 of the 83 patients. The sensitivity, specificity, accuracy, and the area under the ROC curve (Az) for the detection of prostate cancer were as follows: 73%, 54%, 64%, and 0.711, respectively, in protocol A; 84%, 85%, 84%, and 0.905, respectively, in protocol B; and 95%, 74%, 86%, and 0.966, respectively, in protocol C. The sensitivity, specificity, and accuracy were significantly different between the three protocols (P < 0.01).


CONCLUSIONS
In patients with elevated serum PSA levels, the combination of T2W, DWI, and dynamic MRI may be a valuable tool for detecting prostate cancer and avoiding an unnecessary biopsy without missing prostate cancer.
Tanimoto
Akihiro
A
Department of Diagnostic Radiology, School of Medicine, Keio University, Shinanomachi, Tokyo, Japan. t-mri@tt.rim.or.jp
Nakashima
Jun
J
Kohno
Hidaka
H
Shinmoto
Hiroshi
H
Kuribayashi
Sachio
S
D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging; D019786:Gadolinium DTPA; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D012372:ROC Curve; D012680:Sensitivity and Specificity
D003287:Contrast Media; D017430:Prostate-Specific Antigen; D019786:Gadolinium DTPA