Keywords:
Pelvis, Genital / Reproductive system male, MR, MR-Diffusion/Perfusion, MR-Spectroscopy, Contrast agent-intravenous, Cancer, Neoplasia
Authors:
R. S. SHETTY1, A. Kohli2, A. Shetty3; 1MUMBAI, MA/IN, 2Mumbai/IN, 3Mumbai, Maharashtra /IN
DOI:
10.1594/ecr2018/C-2072
Results
- There is a direct correlation between the MRI findings and the histopathology findings.
- The sensitivity and specificity of T2 weighted imaging are 91.1% and 83.3%.
- The sensitivity and specificity of DWI/ADC are 92.1% and 98.1%.
The sensitivity and specificity of DCE are 93.4% and 60.8%.
- The PPV and NPV of T2 weighted imaging are 84.4% and 90.4%.
- The PPV and NPV of DWI are 97.9% and 92.6%.
- The PPV and NPV of DCE are 70.1% and 89.9%
- In our study 17 patients (32.6 percent) revealed carcinoma in both peripheral zones 9 patients (17.3 percent) has involved both peripheral zones and one of the central zone.14 patients (26.9 percent) has shown the involvement of unilateral peripheral zones.
9 patients (17.3 percent) has shown the involvement of unilateral peripheral zone and central zone involvement.
Only 2 patients (3.8 percent) cases have shown involvement of unilateral central zone
- In comparison with 1.5-T imaging,
on a 3T system improvement in spatial or temporal resolution and patient comfort are achieved without the use of an endorectal coil [1]
How to approach a case of prostate MRI and tricks for diagnosis and staging:
- Lack of a uniform T2W hyperintensity in the peripheral zone indicates a pathology
- Next,
look for areas of corresponding DW hyperintensity or ADC drop
- Next look for corresponding focal early arterial enhancement on DCE
- A trick to diagnose a definitive neoplastic etiology would be to look for early arterial enhancement on DCE and then check for corresponding low ADC values
- In our study generally,
a positive early arterial enhancement on DCE with corresponding low ADC values has been diagnostic of a neoplastic etiology