DWI CAPACITY IN PROSTATE CANCER DIAGNOSING

Abstract

Relevance: Prostate cancer is one of the leading causes of cancer deaths in men worldwide. Transrectal ultrasound-guided (TRUS) prostate biopsy is the most important diagnostic step, without which a definitive diagnosis cannot be made. Despite this, TRUS-guided prostate biopsy has a high rate of false negatives and is often accompanied by various clinical complications. Multiparametric MRI (mpMRI) is now widely used in routine urological and oncological practice. An element of mpMRI is diffusion-weighted imaging (DWI), which is successfully used in detecting and localizing clinically significant prostate cancer. The study aimed to evaluate the DWI capacity in diagnosing prostate cancer. Methods: 52 patients, 48-86 years old, with suspected prostate cancer, underwent mpMRI. DWI sequences obtained using T2-weighted imaging (T2WI) were compared with each other and compared with the anatomical structure of the prostate. Suspicious prostate cancer sites were marked as regions of interest, for which an apparent diffusion coefficient (ADC) was calculated. A 12-point TRUS-guided biopsy confirmed the presence or absence of prostate cancer. Results: When analyzing quantitative measurements, ADC showed low values for cancer in the central gland (transitional zone and central zone) – 0.610±0.157×10-3 mm2/s, p=0.0001, and for cancer in the peripheral zone – 0.651±0.228×10-3 mm2/s, p=0.0004, compared to normal tissue. It was found that the highest sensitivity value (87.5%) is typical for ADC central gland, and the lower value for ADC peripheral zone is 75%. The highest specificity value (90.9%) was observed in ADC peripheral zone, and a lower value in ADC central gland – was 84.1%. Conclusion: DWI is an effective non-invasive method for detecting and localizing prostate cancer, providing a qualitative (visual) and quantitative assessment of prostate cancer.