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Prostate cancer screening: The clinical value of diffusion‐weighted imaging and dynamic MR imaging in combination with T2‐weighted imaging
Author(s) -
Tanimoto Akihiro,
Nakashima Jun,
Kohno Hidaka,
Shinmoto Hiroshi,
Kuribayashi Sachio
Publication year - 2007
Publication title -
journal of magnetic resonance imaging
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.563
H-Index - 160
eISSN - 1522-2586
pISSN - 1053-1807
DOI - 10.1002/jmri.20793
Subject(s) - prostate cancer , medicine , receiver operating characteristic , diffusion mri , biopsy , magnetic resonance imaging , prostate , radiology , cancer , protocol (science) , dynamic contrast enhanced mri , prostate specific antigen , nuclear medicine , pathology , alternative medicine
Purpose To evaluate the clinical value of diffusion‐weighted imaging (DWI) and dynamic MRI in combination with T2‐weighted imaging (T2W) for the detection of prostate cancer. Materials and Methods A total of 83 patients with elevated serum prostate specific antigen (PSA) levels (>4.0 ng/mL) were evaluated by T2W, DWI, and dynamic MRI at 1.5 T prior to needle biopsy. The data from the results of the T2W alone (protocol A), combination of T2W and DWI (protocol B), and the combination of T2W+DWI and dynamic MRI (protocol C) were entered into a receiver operating characteristic (ROC) curve analysis, under results of systemic biopsy as the standard of reference. Results Prostate cancer was pathologically detected in 44 of the 83 patients. The sensitivity, specificity, accuracy, and the area under the ROC curve (Az) for the detection of prostate cancer were as follows: 73%, 54%, 64%, and 0.711, respectively, in protocol A; 84%, 85%, 84%, and 0.905, respectively, in protocol B; and 95%, 74%, 86%, and 0.966, respectively, in protocol C. The sensitivity, specificity, and accuracy were significantly different between the three protocols ( P < 0.01). Conclusion In patients with elevated serum PSA levels, the combination of T2W, DWI, and dynamic MRI may be a valuable tool for detecting prostate cancer and avoiding an unnecessary biopsy without missing prostate cancer. J. Magn. Reson. Imaging 2007. © 2006 Wiley‐Liss, Inc.