Prostate carcinoma: Accuracy of diagnosis and differentiation with Dynamic Contrast-Enhanced MRI and Diffusion Weighted Imaging

Diffusion weighted image (DWI) and dynamic contrast enhanced MR imaging (DCE-MRI) provide excellent parameters that are useful for differentiating cancer from normal tissue in prostatic cancer patients. To define the diagnostic value of diffusion weighted image (DWI) and dynamic contrast enhanced MR imaging (DCE-MRI) and determine whether the combination of the two techniques provides higher diagnostic accuracy for prostate cancer than each technique alone. 30 patients suggested to have prostate cancer based on high PSA value underwent MRI examination including axial T2-WI, diffusion weighted image (DWI), apparent diffusion coefficient (ADC) and dynamic contrast enhanced MRI (DCE-MRI). The final diagnosis was confirmed by histopathological study of the TRUS-guided biopsies. The sensitivity of DCE-MRI, ADC at 1.2 and ADC at 1.4 in detection of prostatic carcinoma was 100%, 84.6% and 100% respectively (P = 0.000). The highest validity for cancer prostate is DCE-MRI (Kappa = 0.93) followed by ADC at 1.4 (Kappa = 0.86) then ADC at 1.2 (Kappa = 0.79). DCE-MRI and DWI have high sensitivity to differentiate cancerous from non-cancerous prostatic tissue, and the combination of both techniques increase the diagnostic accuracy of prostatic cancer than each one alone.