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Diagn Interv Radiol. 2011 Sep;17(3):243-8. doi: 10.4261/1305-3825.DIR.3605-10.1. Epub 2010 Sep 22.

Prostate cancer detection with MRI: is dynamic contrast-enhanced imaging necessary in addition to diffusion-weighted imaging?

Author information

1
Department of Radiology, Nissay Hospital, Osaka, Japan. iwazawa.jin@nissayhp.or.jp

Abstract

PURPOSE:

To assess the feasibility of using magnetic resonance imaging for prostate cancer detection without using a contrast material.

MATERIALS AND METHODS:

T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced imaging (DCEI) were performed using a phased-array coil at 1.5 T. These examinations were performed in 178 patients with elevated serum prostate-specific antigen levels ( > 4.0 ng/mL) before systematic needle biopsy. Two radiologists independently evaluated images from DWI, DCEI, and a combination of the two techniques by referring to a T2WI image and by using a predefined confidence scale for cancer detection. The right and left halves of the peripheral zone and the central gland were separately rated. The diagnostic performance (A < sub > z < /sub > ) of each technique was assessed by analyzing their associated area under the receiver operating characteristic curves. The results of a biopsy served as a reference standard.

RESULTS:

Prostate cancer was detected in 72 (40.4%) of the 178 patients. For the entire prostate, the diagnostic performances of DWI (Az = 0.848) (P < 0.001) and the combined technique (Az = 0.845) (P < 0.001) were significantly more accurate than that of DCEI (Az = 0.746). DWI (74.8%) (P < 0.001) and the combined technique (72.9%) (P < 0.001) were significantly more sensitive than DCEI (52.8%). The numbers of cancer lesions that were interpreted using only DWI or DCEI were 83 (26.1%) and 13 (4.1%) of the 318 study lesions, respectively.

CONCLUSION:

DWI and the combined technique are more accurate and sensitive than DCEI in the detection of prostate cancer; however, DWI and DCEI play complementary roles in the accurate detection of prostate cancer.

PMID:
20859852
DOI:
10.4261/1305-3825.DIR.3605-10.1
[Indexed for MEDLINE]
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