Biparametric versus Multiparametric MRI in Cancer Prostate Detection

Abstract

Abstract Background Prostate cancer is the most frequently diagnosed cancer among men in over one-half of the countries of the world. Multi-parametric MRI is currently recognized as the best imaging method for assessment of cancer prostate. Aim of the Work comparing the diagnostic accuracy of mpMRI and bpMRI, according to PI- RADS V2.1 using the histopathological results as the standard of reference. Patients and Methods 41 suspected prostate cancer patients were enrolled in our study based on elevated PSA levels or abnormal digital rectal examination, underwent prostate MRI. Images were interpreted first without DCE-MRI sequence then DCE-MRI was included, and scores were recorded, once for bpMRI and once for mpMRI. Results ROC curve analysis revealed that the AUC for the bpMRI and mpMRI protocols in diagnosing cancer prostate were 0.953 and 0.950 respectively and the difference was not statistically significant (P-value=0.875). Sensitivity, specificity and accuracy were calculated to reveal that when using PI-RADS score of ≥ 3 as a cut-off, bpMRI and mpMRI had exactly the same sensitivity, specificity, accuracy, PPV and NPV (100, 62.5, 85% respectively). When increasing the cut-off point of PI-RADS score to ≥ 4, the sensitivity of bpMRI decreased from 100 to 80, specificity increased from 62.5 to 93.75 yet, accuracy remained the same (85.4%). Whereas the sensitivity of mpMRI remained 100, specificity increased from 62.5 to 68.75 and accuracy increased from 85.4% to 87.8%. Conclusion bpMRI without DCE-MRI sequence did not lead to significant differences in diagnostic accuracy when using PI-RADS V2.1.