Abstract
Purpose: We evaluated the role of multiparametric magnetic resonance imaging (mpMRI) in the diagnosis of prostate cancer and predicting of surgical staging of prostate cancer.
 
 Materials and Methods: The study was done in 110 subjects who got mpMRI before radical prostatectomy in our hospital from 2016 to 2019. Preoperative mpMRI findings of 110 were compared to surgical pathology results following radical Prostatectomy. A comparison was made between pathologic staging of prostate cancer and the mpMRI findings.
 
 Results: pathologic evaluation confirmed prostate cancer foci (237) were recognized in 110 subjects. Generally, mpMRI sensitivity of 46.4% was found for prostate cancer detection (110/237). Pathological tumor volume was a significant predictor of prostate cancer detection using mpMRI. In 33% of the cases, the pathologic staging is precisely similar to mpMRI and in 43%of the cases, there was a slight difference between the pathologic staging and staging by mpMRI but the cancer was confined to the prostate.in 24% of the cases, there was a significant difference between the pathologic staging and staging by mpMRI. The mpMRI was not able to identify the significant cancer in 24% of the cases.
 
 Conclusion: The preoperative mpMRI was useful in detecting prostate cancer and in predicting surgical staging. However, the detection of 24% of clinically significant cancer was missed using mpMRI. As we move toward personalized medicine, use of MRI to biopsy each man's prostate differently rather than based on a pre-defined 12 core seems to be supported in the recent literature.
Highlights
Malignant neoplasms have remained as a leading cause of death worldwide (Abdel-Sattar et al, 2018)
106 (44.7%) tumor lesions on radical prostatectomy specimen were identified as clinically significant cancer
Pathological index tumor volume was the strongest predictor of tumor detection by multiparametric magnetic resonance imaging (mpMRI) with Prostrate Imaging Reporting and Data System (PI-RADS) (P = 0.03)
Summary
Malignant neoplasms have remained as a leading cause of death worldwide (Abdel-Sattar et al, 2018). The diagnostic pathway for prostate cancer detection is initiated on prostate-specific antigen (PSA) level and digital rectal exam (DRE). Use of PSA as a screening tool followed by systematic transrectal ultrasound-guided (TRUS) biopsy has resulted in increased detection of prostate cancer with stage migration toward low-risk disease (Mottet et al, 2017). For evaluation of the clinical staging, routine diagnostics (i.e., digital rectal examination, serum prostate-specifc antigen (PSA) level, transrectal ultrasound, and Gleason score) are insufficient (Carroll et al, 2016). Multiparametric MRI has become a valuable tool in the diagnosis of prostate cancer. The usefulness of MRI for determining the true size and shape of a tumor remains incompletely characterized. The usefulness of MRI for determining the true size and shape of a tumor remains incompletely characterized. (Ukimura et al, 2013)
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