In prostatic carcinoma, the glandular architecture is replaced by cancer cells producing barriers to water motion, anomaly that can be studied through diffusion-enhanced MRI technique. To assess the contribution of these sequences in the prostate cancer exploration, we conducted a descriptive and inferential study using diffusion-enhanced MRI technique in 26 patients with abnormal digital rectal examination (DRE) and increased prostate specific antigen (PSA) values. We analyzed sensitivity, specificity and ROC curves based on apparent diffusion coefficient (ADC). Seven out of 14 biopsies were positive in patients undergoing prostate biopsy. When applying ADC <1000 _m2/se, high sensitivity with low specificity levels, as well as moderate predictive values were obtained. By incorporating T2-weighted images, improved diagnostic accuracy, specificity and predictive values were achieved. When comparing ADC values in tissues with and without cancer, average and minimum ADC appeared to exhibit different values. ROC curves depicted increased and significant values, suggesting cutoff values of 1059 µm 2 /s and 969 µm 2 /s for healthy and malignant tissues, respectively; LR (+) for cutoff value: 6.97 and 5.23, respectively. Our results enable us to propose that improved diagnostic outcomes are attained through combined interpretation of T2-weighted images and diffusion-weighted sequences and that the ADC permits discrimination between normal and malignant tissues. Therefore, we strongly support that these criteria should be taken into account when performing prostate explorations.
Radiological evaluation of response to chemotherapy can be carried out by applying the RECIST (Response Evaluation Criteria in Solid Tu
IntroducciónLa evidencia que aportan las imágenes médicas al diagnóstico, etapificación y seguimiento de lesiones en oncología es de gran relevancia (1) . La interpretación de éstas debe ser lo más objetiva posible, ya que sobre esta base se toman muchas decisiones médico-terapéuticas.En 1979, la Organización Mundial de la Salud (OMS) introdujo los criterios de respuesta de tumores sólidos frente a la quimioterapia, aunque sin especificar protocolos de imagen (WHO, 1979) (2) , por lo que posteriormente muchos grupos propusieron modificaciones que terminaron generando confusión (3) . Con el objetivo de estandarizar los criterios de respuesta, en el año 2000, se introdujo un sistema de medición, puntuación y seguimiento para tumores sólidos denominado RECIST (Response Evaluation Criteria in Solid Tumor (4) ). Este sistema intenta simplificar el sistema WHO que utiliza dos diámetros transversales
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