Purpose:To investigate the utility of apparent diffusion coefficient (ADC) values for discriminating tumor in patients with prostate cancer from normal prostatic tissues in healthy adult men, and to identify correlations between ADC and histologic grade of prostate cancer. Materials and Methods:A total of 125 healthy male volunteers (mean age, 60 years; range, 50 -86 years) and 90 prostate cancer patients (mean age, 71 years; range, 51-88 years) underwent diffusion-weighted imaging (DWI) of the prostate with a single-shot echo-planar imaging sequence using b-factors of 0 and 800 sec/mm 2 . ADC was measured from two locations in the peripheral zone (PZ) and two locations in the central gland (CG) in normal subjects, and tumor locations of PZ or transition zone (TZ) in patients with prostate cancer. Results:Mean ADC values of tumor regions in both PZ (1.02 Ϯ 0.25 ϫ 10 Ϫ3 mm 2 /sec) and TZ (0.94 Ϯ 0.21 ϫ 10 Ϫ3 mm 2 /sec) were significantly lower than those in the corresponding normal regions (1.80 Ϯ 0.27 ϫ 10 Ϫ3 mm 2 /sec and 1.34 Ϯ 0.14 ϫ 10 Ϫ3 mm 2 /sec, respectively) (P Ͻ 0.0001 each). Furthermore, a significant negative correlation was identified between ADC in PZ cancer and tumor Gleason score ( ϭ Ϫ0.497, P Ͻ 0.0001). Conclusion:ADC values appear to provide acceptable diagnostic accuracy in both PZ and TZ.

Objectives:The aim of the present study was to explore the effects of three different types of alpha-1 adrenoceptor blockers (a1-blocker) on lower urinary tract symptoms (LUTS), erectile dysfunction (ED) and ejaculatory dysfunction (EjD) in patients with benign prostatic hyperplasia. Methods: A total of 136 male LUTS patients aged 50-80 years with International Prostate Symptom Score (IPSS) Ն8 were enrolled. They were divided into three groups. Group S received silodosin at 4 mg twice a day; group T received tamsulosin at 0.2 mg once a day; and group N received naftopidil at 50 mg once a day. Assessment included IPSS, quality of life indexes (QOL), International Index of Erectile Function (IIEF-5), an ejaculation questionnaire, Qmax and post-void residual urine volume (PVR). These parameters were recorded at baseline, and at 1 and 3 months after treatment had ended. Results: Mean IPSS and Qmax significantly improved after treatment in all groups without any significant difference among them. As for the IIEF-5 score, only group N significantly improved at 1 and 3 months. After treatment, 2.6 and 2.4% of patients complained of a de novo reduced volume of ejaculation in both groups T and N, respectively. Ten out of 41 patients (24.4%) complained of a total absence of antegrade ejaculation in group S after treatment. Conclusions: All three types of a1-blockers provided an objective and subjective improvement of LUTS in the present study population. However, erectile function only improved in patients treated with naftopidil and a higher rate of EjD was observed in those receiving silodosin. Because of their variable effects, we should consider the sexual dimension when prescribing a1-blockers for LUTS.

Interpretation of combined T2-weighted, dynamic contrast-enhanced, and DW MR image findings can yield reasonable diagnostic accuracy in both the PZ (80% [191 of 240 regions]) and the TZ (74% [59 of 80 regions]).

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Combined T2-weighted imaging, DWI, and DCE-MRI findings appear to be potentially useful for detecting and managing prostate cancer, even when performed for patients with gray-zone PSA levels.