Diagnostic Accuracy of Multiparametric Magnetic Resonance Imaging in Peripheral Zone Prostate Cancer Detection

Pornphan Wibulpolprasert; Sasiprapa Rongthong; Sith Phongkitkarun; Panas Chalermsanyakorn

doi:10.14456/rmj.2018.31

Authors

Pornphan Wibulpolprasert Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Sasiprapa Rongthong Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Sith Phongkitkarun Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
Panas Chalermsanyakorn Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand

DOI:

https://doi.org/10.14456/rmj.2018.31

Keywords:

Prostate cancer, Peripheral zone, Multiparametric MRI, Diagnostic accuracy

Abstract

Background: Multiparametric magnetic resonance imaging (mp-MRI) has emerged as the best noninvasive imaging modality for prostate cancer detection, grading, staging, and targeted biopsy guidance. Validate performance of mp-MRI for peripheral zone prostate cancer detection is important for clinical implication.

Objective: To determine the accuracy of T2-weighted (T2W) imaging, diffusion-weighted imaging (DWI), three dimensional (3D) magnetic resonance spectroscopic (MRS) and dynamic contrast-enhanced imaging (DCE) in peripheral zone prostate cancer detection.

Methods: The retrospective study included 38 patients who has undergone pre-operative endorectal MRI from March 2006, to March 2010. The correlation of T2W, DWI, MRS and DCE in differentiation between tumor and non-tumor areas were analyzed by using Pearson's chi-square test or Fisher’s exact test. The receiver operating characteristic (ROC) analysis was use to evaluate the distinguishing ability of T2W, DWI, MRS, DCE, and the combinations in tumor detection.

Results: In 76 lesions from 38 patients, the area under the ROC curve (AUC) for tumor detection was 0.86 (T2W), 0.86 (DWI), 0.95 (MRS), and 0.61 (DCE). Combination of T2W+DWI, T2W+MRS, T2W+DCE achieved an AUC of 0.86, 0.92, and 0.80, respectively. There is no statistically significant difference in AUC between combination of T2W+DWI (0.86), and combination of T2W+DWI+DCE (0.82), T2W+DWI+MRS (0.81), or T2W+DWI+MRS+DCE (0.78).

Conclusions: DWI is the most useful complementary sequence to conventional anatomical T2W imaging for prostate cancer foci identification. The 3D-MRS and DCE images may be use as confirmation tools in peripheral zone prostate cancer detection.

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