Keywords:
Genital / Reproductive system male, Urinary Tract / Bladder, Oncology, MR-Diffusion/Perfusion, Imaging sequences, Neoplasia
Authors:
M. Barral, X. Belin, F. Mellot, Y. Neuzillet, A. Scherrer; Suresnes/FR
DOI:
10.1594/ecr2013/C-1373
Purpose
To retrospectively investigate prevalence and characteristics of Diffusion-weighted b2000 negative images of histologically proven Gleason > or = 7 prostate adenocarcinomas.
BACKGROUND:
Prostate cancer is a 4th most common of all cancer and the most common in men adults with a mean age of diagnosis of 72-74 years old.
Results of autopsy studies suggest that most men over 85 years old have latent PCa disease.
However,
Prostate Cancer has a very good prognosis with a 15-years relative survival of 91% (1).
Prostatic MR is routinely used for staging before surgery (detection of extra prostatic spreading)
New indications are now rising (2):
- Pre biopsy evaluation (elevated PSA,
negative first sery of biopsy
- Prostate mapping (planning surgery)
- Follow-up (recurrence detection)
If the ability of DW MR Imaging to differentiate aggressive from mild cancer is proven,
then DW MRI will be the cornerstone of active surveillance of low risk prostate cancer avoiding repeated biopsies as well as a must to plan localized therapies.
According to the literature DWI with high b value is a robust sequence to show evidence of tumour with more than Gleason grade 4 components (5).