Multiparametric MRI (mpMRI) provides a noninvasive approach to the characterization of prostate anatomy,
cell density and metabolism (T2 weighted image (T2w),
dynamic contrast enhance (DCE) sequences and diffusion weighted image (DWI) and spectroscopy respectively) not just for local staging,
but also for the initial diagnosis of prostatic carcinoma ,
having emerged as a new and important tool in the field.
Even though there is supportive evidence for the use of mpMRI,
the lack of standardization of diagnostic criteria has stalled the wide application of...
Methods and Materials
Patients: In 2008 our institution began routinely performing mpMRI of the prostate.
The gross of the studies were acquired for local staging,
restaging and postsurgical evaluation.
We reviewed our hospital records for:
Patients referred by urologists under suspicion of prostatic carcinoma (elevation of PSA) and at least one previous TRUS biopsy in which a new targeted biopsy was considered. [Following mpMRI,
all patients underwent targeted TRUS biopsies performed by the urologists,
who were aware of the imaging findings.]
14 patients met the inclusion criteria.
14 patients with a mean age of 66.78 +/-6.38 (range 54-76 years)
At least one previous negative TRUS biopsy.
Mean number of biopsies 3.64 (range 1-6).
PSA previous to the mpMRI was elevated in all the patients.
Mean value 20.59+/-10.67 (range 7.77-52.61).
All patients underwent biopsy following MRI with a median interval of 94.71 days +/-90.67 (range 8-287).
The biopsy was positive for cancer in 6 patients (42.85%).
The maximal Gleason score was 4+5 (n=1),
Patients with negative...
The recommended use of MRI in prostate cancer is multiparametric.
The integration of technics such as DWI,
DCE and spectroscopy has been shown to increase the sensibility and specificity of prostate cancer detection ,
reaching predictive values of up to 80% .
We found the PI-RADS score system to be a reliable reporting system for the mpMRI with fairly good interobserver agreement,
with the highest kappa for the T2w image and DCE sequence.
A positive relationship not only between the T2w image and DWI scores,...
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