Objective: To assess the diagnostic accuracy of
magnetic resonance imaging (MRI) for prostate cancer
with multiple parameters.
Methods: Patients who underwent both MRI and
transrectal ultrasound-guided biopsy from July 2012
to August 2014, were reviewed retrospectively.
Multiple parameters were assessed to determine the
accuracy of MRI for prostate cancer; the apparent
diffusion coefficient (ADC), dynamic contrast enhanced
MRI (DCE-MRI), and the Cho/cit and (Cho+creat)/cit
ratios. The areas under the receiver operating
characteristic curves (AUC) were used to evaluate the
diagnostic accuracy of metabolic ratios.
Results: Thirty-six lesions from 28 patients were
analyzed. Malignant lesions at the peripheral zone
showed significantly lower ADCs than benign lesions
(p < 0.01). If lesion size was 1 cm or larger, the
(Cho+creat)/cit ratio was significantly higher (p < 0.01).
The ADCs had a high specificity of 87.5%, an accuracy
of 77.8%, and AUC of 0.68. DCE-MRI had high
specificity of 91.7%, accuracy of 83.3%, and an AUC
0.78. The Cho/cit ratios showed a high sensitivity of
91.7%, but low specificity of 54.2%. The greatest AUC
was 0.85 when the DCE-MRI was combined with the
Cho/cit ratio, giving an accuracy of 83.3%. No
significant improvement was established, however,
when all 3 parameters were combined together.
Conclusion: DCE-MRI and ADC had greater diagnostic
accuracy than MR spectroscopy (MRS). Combined parameters improved specificity for prostate cancer
lesions.
Keywords
Diagnostic accuracy Magnetic resonance imaging; Prostate cancer Sensitivity Specificity Apparent diffusion coefficient dynamic contrast enhanced MRI Cho cit ratio (Cho+creat) cit ratio