Abstract
Background: Magnetic Resonance Imaging (MRI) plays a vital role in diagnosing prostatic cancer routinely done before biopsy for the lesion's extent and defining the correct path for ultrasound-guided prostate biopsy. Diffusion-Weighted Imaging (DWI) is a non-invasive MRI sequence that shows improved sensitivity and specificity in the same setting with no additional cost. The study aims to evaluate the diagnostic accuracy of DWI in the detection of prostatic cancer.
 Methodology: A cross-sectional study was conducted at the radiology department of Dr. Ziauddin University Hospital between 15/ 04 /2016 to 15/ 4 /2017. A total of 201 patients who were clinically suspected of having prostatic tumors were in this study's inclusion criteria. MRI, including DWI, was done. The final diagnosis was based on an analysis of the histopathology report.
 Results: Out of 201 males with clinical suspicious of prostatic cancer, 160 were diagnosed with prostatic cancer on histopathology. Of these, 150 were positive on DWI. The sensitivity of diffusion-weighted MRI was found to be 93.7%, 75.60% specificity, and 90.0% diagnostic accuracy (DA) for the diagnosis of prostatic cancer.
 Conclusion: Diffusion-weighted sequence in MRI examination has a vital role in diagnosing prostatic cancer and should be considered a routine pre-biopsy investigation along with MRI in clinically suspected cases of prostate cancer.
Highlights
According to the 2012 American Cancer Society statistics, the most common cause of a new cancer diagnosis is prostate cancer and a frequent cancer death[1,2]
We have reported better diagnostic accuracy (DA) of diffusion-weighted Magnetic Resonance Imaging (MRI) in diagnosing prostatic cancer[33]
Diffusion-Weighted Imaging (DWI) is an additional MRI sequence that needs no extra preparation, no additional cost, and takes much less time than other sequences; it has a vital role in detecting prostatic cancer
Summary
According to the 2012 American Cancer Society statistics, the most common cause of a new cancer diagnosis is prostate cancer and a frequent cancer death[1,2]. It has been reported that trans-rectal ultrasound-guided biopsies can miss up to 30 % of the tumor. According to the previous studies, TRUS biopsy has underestimated the Gleason score of prostatic cancer on histopathology, which results in inaccurate diagnosis and inappropriate further management. Magnetic Resonance Imaging (MRI) plays a vital role in diagnosing prostatic cancer routinely done before biopsy for the lesion's extent and defining the correct path for ultrasound-guided prostate biopsy. The sensitivity of diffusion-weighted MRI was found to be 93.7 %, 75.60 % specificity, and 90.0 % DA for the diagnosis of prostatic cancer. Conclusion: Diffusion-weighted sequence in MRI examination has a vital role in diagnosing prostatic cancer and should be considered a routine pre-biopsy investigation along with MRI in clinically suspected cases of prostate cancer
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