The role of multiparametric magnetic resonance imaging in the diagnosis, localisation and local staging of prostatic carcinoma

Abstract Background: This study evaluates the role of multiparametric magnetic resonance imaging (mpMRI) in prostate cancer. The aim of the study was to determine the sensitivity, specificity and accuracy of mpMRI in the detection of prostatic carcinoma (PCa) and in the local staging of PCa. Methods: The prospective observational study was carried out on 78 patients with suspected prostate cancer in a tertiary care hospital in India. All scans were performed on a 1.5 Tesla MRI machine (MAGNETOM Avanto, Siemens Medical Solutions, Erlangen, Germany) using T2-weighted imaging (T2WI), T1-weighted imaging (T1WI), diffusion-weighted imaging (DWI), dynamic contrast-enhanced MRI (DCE-MRI), magnetic resonance spectroscopy (MRS) and Prostate Imaging-Reporting and Data System (PI-RADS) scoring. The findings of PI-RADS scoring of multiparametric MRI are compared with histopathological diagnosis. Results: The diagnostic accuracy of mpMRI using PI-RADS was 86%. Analysis of T2 + DWI + DCE using PI-RADS Version 2 showed an increase in specificity from 73% to 81%, with an overall increase in accuracy from 79.5% to 84% for the same data, compared to PI-RADS Version 1. This accuracy, sensitivity and specificity are almost equal to the mpMRI (including MRS) Version 1. Conclusions: We found mpMRI to be an excellent diagnostic modality in the evaluation of PCa. Out of the three functional MRI techniques, DWI was found to be the most accurate, with DCE-MRI showing the lowest accuracy and MRS the lowest sensitivity.