Prostate cancer. Future of using quantitative magnetic resonance imaging

Background. Prostate cancer is the 2nd most common malignant neoplasms among adult males. Magnetic resonance imaging (MRI) is the method of choice in radiological diagnostics of this disease allowing to noninvasively evaluate the prostate. Currently, the PI-RADS (Prostate Imaging Reporting and Data System) system is widely used. However, its assessment is subjective, or “by eye”, therefore the possibility of enhancing qualitative analysis with quantitative should be considered an excellent prospect.Aim. To determine correlations between the apparent diffusion coefficient (ADC) and PI-RADS score which will allow to move from subjectivity in evaluation of prostate MRI results and make them independent of radiologists’ experience.Materials and methods. The pilot retrospective study included MRI data of 28 patients with verified prostate cancer from the period between 2020 and 2022.Results. Total PI-RADS score showed strong statistically significant negative correlation with mean ADC (r = –0.85; p 0.001) and minimum ADC (r = –0.82; p 0.001). PI-RADS score correlation with prostate-specific antigen level did not show statistical significance (p = 0.162). Total regression was statistically significant (R2 = 0.73; F (4.13) = 8.799; p = 0.001). It was found that PI-RADS score depended on mean ADC (p 0.001) and prostate-specific antigen level (p = 0.013). Additionally, linear regression models were developed to predict Gleason score but with the current dataset they did not show statistical significance, possibly due to the small sample size.Conclusion. The use of quantitative MRI in diagnosis of prostate cancer is a promising method which allows to objectivate PI-RADS score and to decrease the number of unjustified biopsies in the future. The key reason why quantitative MRI cannot be widely implemented is that ADC values are affected by a large number of external parameters, and ADC values can significantly vary in different devices. Therefore, in the future standardization of the prostate scanning protocol with optimal selection of b-value and minimization of factors affecting ADC measurement will allow to achieve more reliable comparative metrics.