title: Feasibility of multiparametric prostate magnetic resonance imaging in the detection of cancer distribution: histopathological correlation with prostatectomy specimens.
abstract: OBJECTIVE
  To prevent overtreatment, it is very important to diagnose the precise distribution and characteristics of all cancer lesions, including small daughter tumors. The purpose of this study was to evaluate the efficacy of T2-weighted magnetic resonance imaging (T2W), diffusion-weighted magnetic resonance imaging (DWI), magnetic resonance spectroscopy ((1)H-MRS), and prostate biopsy (PBx) in the detection of intraprostatic cancer distribution.
  
  
  METHODS
  All patients underwent T2W, DWI, (1)H-MRS, and PBx followed by radical prostatectomy (RP). Individual prostates were divided into 12 segmental regions, each of which was examined for the presence or absence of malignancy on the basis of T2W, DWI, (1)H-MRS, and PBx, respectively. These results were compared with the histopathological findings for RP specimens.
  
  
  RESULTS
  We included 54 consecutive patients with biopsy-proven prostate cancer (mean age, 62.7 years; median prostate-specific antigen level, 5.7 ng/mL) in this study. We could detect cancer in 247 of 540 evaluable lesions. The area under the receiver operator characteristic curve analysis yielded a higher value for DWI (0.68) than for T2W (0.65), (1)H-MRS (0.54), or PBx (0.56). In 180 cancerous regions of RP specimens with false-negative PBx results, T2W+DWI had the highest positive rate (53.3%) compared with that of each sequence alone, including T2W (45.6%), DWI (41.1%), and (1)H-MRS (30.0%).
  
  
  CONCLUSIONS
  Multiparametric magnetic resonance imaging (T2W, (1)H-MRS, DWI) enables the detection of prostate cancer distribution with reasonable sensitivity and specificity. T2W+DWI was particularly effective in detecting cancer distribution with false-negative PBx results.
authors.affiliation: Department of Urology, Teikyo University School of Medicine, Tokyo, Japan ; Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kitamura
authors.affiliation: Department of Urology, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Muto
authors.affiliation: School of Integrated Health Science, Faculty of Medicine, The University of Tokyo, Tokyo, Japan.
authors.forename: Isao
authors.initials: I
authors.lastname: Yokota
authors.affiliation: Departments of Pathology, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Kazutane
authors.initials: K
authors.lastname: Hoshimoto
authors.affiliation: Departments of Radiology, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Tatsuro
authors.initials: T
authors.lastname: Kaminaga
authors.affiliation: Department of Urology, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Noguchi
authors.affiliation: Department of Urology, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Syou-Ichiro
authors.initials: S
authors.lastname: Sugiura
authors.affiliation: Department of Urology, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Hisamitsu
authors.initials: H
authors.lastname: Ide
authors.affiliation: Department of Urology, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Raizo
authors.initials: R
authors.lastname: Yamaguchi
authors.affiliation: Departments of Radiology, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Furui
authors.affiliation: Department of Urology, Juntendo University, Graduate School of Medicine, Tokyo, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Horie
keywords: Diffusion magnetic resonance imaging; Magnetic resonance imaging; Magnetic resonance spectroscopy; Prostate neoplasms