Abstract
BackgroundSusceptibility weighted imaging (SWI) is a new MRI technique which has been proved very useful in the diagnosis of brain diseases, but few study was performed on its value in prostatic diseases. The aim of the present study was to investigate the value of SWI in distinguishing prostate cancer from benign prostatic hyperplasia and detecting prostatic calcification.Methodology/Principal Findings23 patients with prostate cancer and 53 patients with benign prostatic hyperplasia proved by prostate biopsy were scanned on a 3.0T MR and a 16-row CT scanner. High-resolution SWI, conventional MRI and CT were performed on all patients. The MRI and CT findings, especially SWI, were analyzed and compared. The analyses revealed that 19 out of 23 patients with prostate cancer presented hemorrhage within tumor area on SWI. However, in 53 patients with benign prostatic hyperplasia, hemorrhage was detected only in 1 patient in prostate by SWI. When comparing SWI, conventional MRI and CT in detecting prostate cancer hemorrhage, out of the 19 patients with prostate cancer who had prostatic hemorrhage detected by SWI, the prostatic hemorrhage was detected in only 7 patients by using conventional MRI, and none was detected by CT. In addition, CT demonstrated calcifications in 22 patients which were all detected by SWI whereas only 3 were detected by conventional MRI. Compared to CT, SWI showed 100% in the diagnostic sensitivity, specificity, accuracy, positive predictive value(PPV) and negative predictive value(NPV) in detecting calcifications in prostate but conventional MRI demonstrated 13.6% in sensitivity, 100% in specificity, 75% in accuracy, 100% in PPV and 74% in NPV.ConclusionsMore apparent prostate hemorrhages were detected on SWI than on conventional MRI or CT. SWI may provide valuable information for the differential diagnosis between prostate cancer and prostatic hyperplasia. Filtered phase images can identify prostatic calcifications as well as CT.
Highlights
Prostate cancer is the fifth most common cancer [1] and become a major worldwide public health problem [2], which causes 6% of cancer deaths in men [1]
More apparent prostate hemorrhages were detected on Susceptibility weighted imaging (SWI) than on conventional magnetic resonance imaging (MRI) or CT
The tumor lesions of 19 patients with prostate cancer were located in the peripheral zone of the prostate, only 4 cases were within the central region
Summary
Prostate cancer is the fifth most common cancer [1] and become a major worldwide public health problem [2], which causes 6% of cancer deaths in men [1]. Susceptibility weighted imaging (SWI) is a new MRI technology which reflects the magnetic susceptibility of tissue and is exquisitely sensitive to paramagnetic deoxygenated blood products such as deoxyhemoglobin, methemoglobin and haemosiderin [5]. It includes magnitude information and useful phase information, which was usually ignored in most diagnostic MR imaging. This study investigated the value of high-resolution SWI and filtered phase image in distinguishing prostate cancer from benign prostatic hyperplasia and detecting calcification by comparing with conventional MR and CT images. The aim of the present study was to investigate the value of SWI in distinguishing prostate cancer from benign prostatic hyperplasia and detecting prostatic calcification
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