Abstract

BackgroundProstate cancer (PCa) is considered to be the commonest cancer among males. Early and precise diagnosis of PCa is essential for adequate treatment. Multiparametric MR imaging (mpMRI) is actually the most precise imaging technique used for early diagnosis of PCa. The aim of this work was to assess the diagnostic capability of biparametric MRI (bpMRI) and multiparametric MRI (mpMRI) of PI-RADS V2.1 in detection of prostate cancer (PCa). This prospective study was carried on 60 male patients with high PSA. bpMRI and mpMRI were performed for all patients using a 3-T MRI scanner. The diagnostic performance of bpMRI of PI-RADS V2.1 was compared to that of mpMRI of PI-RADS V 2.1. The diagnosis of Pca was confirmed by transrectal ultrasound-guided biopsy and the results of open prostatectomy specimens.ResultsWhen considering PI-RADS categories 1, 2, and 3 as benign and categories 4 and 5 as malignant, mpMRI had higher sensitivity and diagnostic accuracy when compared with bpMRI (sensitivity was 88.6% for mpMRI versus 60% for bpMRI and diagnostic accuracy was 91.7% for mpMRI versus 75% for bpMRI). When considering PI-RADS categories 1 and 2 as benign and PI-RADS categories 3.4 and 5 as malignant, the sensitivity and diagnostic accuracy of bpMRI and mpMRI were comparable (sensitivity was 94.3% for both bpMRI and mpMRI and diagnostic accuracy was 86.7% for both bpMRI and mpMRI).ConclusionConsidering PI-RADS scores 4 and 5 as malignant, mpMRI had higher sensitivity and diagnostic accuracy when compared with bpMRI; however, when considering PI-RADS scores 3, 4, and 5 as malignant, both bpMRI and mpMRI had similar diagnostic accuracy.

Highlights

  • Prostate cancer (PCa) is considered to be the commonest cancer among males

  • Like PIRADS V 2, In prostate imaging reporting and data system (PI-RADS) 2.1, dynamic contrast enhancement (DCE) has a minor role in the detection of clinically significant prostate cancer (DCE is fundamentally utilized to raise lesions in the peripheral zone (PZ) from category 3 to category 4 based on positive findings on DCE)

  • Some previous studies stated that the diagnostic performance of biparametric MRI (T2WI and diffusion-weighted imaging (DWI)) is nearly similar to that of Multiparametric MR imaging (mpMRI) in the detection of clinically significant prostate cancer (csPca), and they recommended omitting DCE-MRI from the protocol used for the diagnosis of Pca because it is time-consuming and because of the side effects of contrast media [7,8,9,10,11,12]

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Summary

Introduction

Prostate cancer (PCa) is considered to be the commonest cancer among males. Early and precise diagnosis of PCa is essential for adequate treatment. Multiparametric MR imaging (mpMRI) is the most precise imaging technique used for early diagnosis of PCa. The aim of this work was to assess the diagnostic capability of biparametric MRI (bpMRI) and multiparametric MRI (mpMRI) of PI-RADS V2.1 in detection of prostate cancer (PCa). The aim of this work was to assess the diagnostic capability of biparametric MRI (bpMRI) and multiparametric MRI (mpMRI) of PI-RADS V2.1 in detection of prostate cancer (PCa) This prospective study was carried on 60 male patients with high PSA. There is usually debate regarding the role of DCE in the diagnosis of PCa. Some previous studies stated that the diagnostic performance of biparametric MRI (bpMRI) (T2WI and DWI) is nearly similar to that of mpMRI in the detection of csPca, and they recommended omitting DCE-MRI from the protocol used for the diagnosis of Pca because it is time-consuming and because of the side effects of contrast media [7,8,9,10,11,12]. The unique of this study is that we compared bpMRI with mpMRI of PIRADS v2.1 in the diagnosis of PCa at 3-T MRI

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