Identification and Localization of Prostate Cancer with Combined Use of T2-Weighted, Diffusion Weighted MRI and Proton MR Spectroscopy, Correlation with Histopathology

Baki Hekimoğlu, Hasan Aydin, Volkan Kızılgöz, İdil Güneş Tatar, Ali Rıza Ugan, İrem Paker

Pathology Department, D??kap? Y?ld?r?m Beyaz?t Education and Research Hospital, Ankara, Turkey.
Radiology Department, D??kap? Y?ld?r?m Beyaz?t Education and Research Hospital, Ankara, Turkey.
Urology Department, D??kap? Y?ld?r?m Beyaz?t Education and Research Hospital, Ankara, Turkey.

DOI: 10.4236/ami.2013.33005                

Abstract

Purpose: To predict the diagnostic performance of combined use of T2-weighted imaging (T2W)-diffusion weighted MRI (DWI) and apparent diffusion coefficient (ADC)-proton MR spectroscopy (H-MRS) for the detection of prostate cancer, correlated to histopathology as the reference standard. Method: After institutional review board approval, 40 patients with prostate cancer were included in this retrospective research. Two readers evaluated the results of T2W, DWI-ADC mapping and H-MRS independently for the depiction of prostate cancer. Reference standard was the TRUS-guided biopsy and the surgical histopathological results. Statistical analysis was assessed by Fisher’s exact t-test, Wilcoxon signed rank test, variance analysis test with Kappa (k) values and receiver operating characteristics (ROC) curve for ADC values, Cho/Cit and Cho + Cre/Cit ratios for each observer. Results: Both readers declined 46% sensitivity and 68% specificity for T2W sequence, 29% sensitivity and 82% specificity for DWI-ADC mapping and 49% specificity for Cho/Cit and Cho + Cre/Cit ratios, 69% sensitivity for Cho/Cit 70% sensitivity for Cho + Cre/Cit ratios of H-MRS. T2W + DWI-ADC mapping + H-MRS (Cho/Cit and Cho + Cre/Cit ratios) regarded 81% sensitivity and 66% specificity, with significant statistical differences to the reference histopathology (p < 0.05). Conclusion: Combination of T2W, DWI and H-MRS were more sensitive and more accurate than either sequences alone, for prostate cancer localization and detection.

Keywords

MRI; Prostate Cancer; DWI; H-MRS; T2W

Conflicts of Interest

The authors declare no conflicts of interest.

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