Assessment of the accuracy of multi-parametric MRI with PI-RADS 2.0 scoring system in the discrimination of suspicious prostatic focal lesions

Abstract

ObjectivesAssessing the value of Mp-MRI with PI-RAD2.0 in distinguishing between malignant and benign prostatic lesions. Patients & methods55 patients with suspicious prostatic lesions underwent PR examination, PSA tests, TRU/S, and Mp-MRI prostate. Mean age was 62years and imaging data were correlated with histopathological data. ResultsHistopathology results revealed 38 malignant lesions and 17 were benign. DWI showed significant restriction with low ADC value, 0.89±0.24μm2/ms in 30 PZ lesions that diagnosed to be likely malignant, (3–5 score) and 7 benign lesions showed no diffusion abnormality with ADC values, 1.34±0.21μm2/ms which were statistically significantly higher than those of malignant lesions (P<0.001). Of the 18 TZ lesions, T2WI diagnosed 7 to be likely malignant (score 3–5) and 11 were benign (1–2 score). DCE-MRI revealed positive results in 28 PZ and 8 TZ lesions. Adding DCE-MRI to DWI and T2WI score in equivocal lesions raises its score from 3 to 4 in 6/9 lesions that aid in malignant lesions diagnosis. Negative enhancement was noted in 9 PZ and 10 TZ benign lesions (−ve). ConclusionMulti-parametric MRI with PI-RAD V2 scoring system was proved to be non invasive and accurate tool for distinguishing between malignant and benign prostatic lesions.