Accuracy of Multi-Parametric MRI in Prostate Cancer Diagnosis

Abstract

Background: When it comes to male cancers, prostate cancer is the second most common malignancy on a global scale. A transrectal  ultrasound-guided biopsy (TRUS-biopsy) could be performed to diagnose prostate cancer in men who have an elevated blood prostate  specific antigen (PSA).

Objective: To determine whether males with elevated PSAs might safely forego unnecessary biopsy by using  multi-parametric magnetic resonance imaging (MP-MRI) as a triage test.

Patients and Methods: The study was conducted at Badr  University Hospital and Nasr-City Health Insurance Hospital on 60 patients with clinical suspicion of prostate cancer. The duration of the  study was 12 months.

Results: The Multiparametric MRI findings recorded; 10% of patients had prostatitis, 65% had prostatic cancer and  25% had benign prostatic hyperplasia (BPH). Regarding TRUS-biopsy findings, 60% of the patients were positive for cancer prostate, and  40% of the population were negative. The mean serum (PSA) for the patients was 12.34 (ng/mL) with SD 2.98. The MP-MRI was able to  correctly identify 33 out of 36 patients with carcinoma (when the comparison is made with the (TRUS-biopsy). It could also exclude 18 out  of 24 patients without carcinoma when compared to the biopsy. The sensitivity of MP-MRI was 91.7 %, specificity was 75%, positive  predictive value (PVP) was 84.6 % and negative predictive value (PVN) was 85.7%. There was moderate agreement between both  techniques (k= 0.68).

Conclusion: Using multi-parametric MRI could lead to a decrease in needless biopsies and an increase in the  number of clinically meaningful prostate cancer diagnoses, perhaps preventing overdiagnosis and overtreatment.