Value of reduced field-of-view diffusion-weighted MRI for prostate cancer detection in the TRUS-guided transperineal prostate biopsy

Abstract

Objective To observe the value of reduced field-of-view diffusion-weighted MRI (rFOV DWI) for prostate cancer (PCa) detection in the TRUS-guided transperineal prostate biopsy. Methods A total of 54 patients with suspected PCa underwent rFOV DWI before TRUS-guided prostate biopsy were prospectively enrolled in this study. All rFOV DWI data were carried out by two independent radiologists using prostate imaging-reporting and data system (PI-RADS) assessment category, and systemic 10-core biopsy (SB) combined with rFOV DWI targeted biopsy (rFOV DWI-TB) were taken. According to histopathology results, the performance of rFOV DWI was analysed. Additionally, the detection rate of PCa and the positive rate of punctures of SB, rFOV DWI-TB and SB combined with rFOV DWI-TB were compared. Results Overall, 26 of the 54 patients (48.15%) had histologically confirmed PCa. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for detecting PCa with rFOV DWI was 80.77%, 89.29%, 87.5% and 83.33%, respectively. The ROC curve analysis revealed the AUC was 0.916. Additionally, the sensitivity for detecting clinically significant PCa with rFOV DWI was 95%. The PCa detection rate of SB, rFOV DWI-TB, and combination of SB and rFOV DWI-TB was 37.04%, 42.59% and 48.15%, respectively. The detection rate for combination of SB and rFOV DWI-TB was significantly higher than that of SB only (P=0.031). Additionally, the detection rate for rFOV DWI-TB cores (78.33%) was significantly better than for SB cores (15.5%)(χ2=124.377, P=0.000). Conclusions rFOV DWI may be useful for providing more information of PCa lesions in targeted prostate biopsy, and has potential value in clinically significant PCa detecting. Key words: Prostatic Neoplasms; Magnetic Resonance Imaging; Biopsy, Needle; Ultrasonography