Accuracy of Multi-parametric Magnetic Resonance Imaging for Diagnosis of Prostate Cancer
Keywords:
Diagnostic accuracy; Magnetic resonance imaging; Prostate cancer; Sensitivity; Specificity; Apparent diffusion coefficient, dynamic contrast enhanced MRI; Cho/cit ratio, (Cho creat)/cit ratioAbstract
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.
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