The Correlation between Diffusion-Weighted Imaging and Histopathological Evaluation of 356 Prostate Biopsy Sites in Patients with Prostatic Diseases

Abstract

Purpose. The aim of this study is to investigate the reliability of diffusion MRI for detection of cancer foci by comparing diffusion-weighted imaging (DWI) results and pathology results of prostate biopsy sites. Methods. Of the patients who applied with lower urinary tract symptoms, 36 patients who had suspected DRE and/or PSA ≥2.5 ng/mL were included in the study. Patients underwent DWI prior to 10 cores-prostate biopsy. 356 biopsy cores were obtained from the patients. Foci from the patients with prostate cancer were labeled as malignant or benign foci, likewise foci from the patients with benign pathology were grouped as BPH and inflammation foci. Apparent diffusion coefficients (ADCs) of biopsy groups were compared with each other in order to measure the reliability of DWI in detection of PCa foci. Results. When ADC values of adenocarcinoma foci and BPH foci were compared, a statistically significant difference was found (P < 0.001). When ADC values obtained from adenocarcinoma foci and chronic inflammation foci are compared, the difference between two groups is statistically significant, too (P < 0.001). Conclusions. Biopsies focused on suspected regions after formation of ADC maps by means of DWI would provide to start definitive treatment immediately as well as being beneficial to prevent morbidity related to repeated prostate biopsies.

Prostate cancer recurrence after radical prostatectomy: the role of 3-T diffusion imaging in multi-parametric magnetic resonance imaging

“…e ADC map, where the ROI was placed Nowadays there is growing interest in DW-MRI, because of its non-invasiveness and because it can be performed without contrast agent administration. It is a powerful tool in detecting prostate cancer [25][26][27][28] and localising prostate cancer recurrence in patients with biochemical failure after definitive radiotherapy [12].…”

Supporting prostate cancer focal therapy: a multidisciplinary International Consensus of Experts (“ICE”)

“…Also, Diffusion-Weighted Imaging (DWI) may increase the efficacy of prostate biopsy by distinguishing localization of cancer foci from the benign ones, minimizing the need for third or more biopsies and the related morbidity [36].…”

Advanced Imaging for the Early Diagnosis of Local Recurrence Prostate Cancer after Radical Prostatectomy

“…It is a powerful tool in detecting and localizing PCa recurrence in patients with biochemical progression after definitive radiation therapy [77, 78]. In a recent study Giannarini et al described five patients with biochemical failure after RP and pelvic lymph node dissection in whom locoregional relapse could only be depicted with DWI [79].…”

“…Nowadays there is an increasingly growing interest in the use of DWI because it is an emergent, noninvasive technique that can be acquired without the intravenous injection of contrast medium, and it does not require long acquisition times and therefore it can be considered the functional technique more practical and simple to use [ 76 ]. It is a powerful tool in detecting and localizing PCa recurrence in patients with biochemical progression after definitive radiation therapy [ 77 , 78 ]. In a recent study Giannarini et al described five patients with biochemical failure after RP and pelvic lymph node dissection in whom locoregional relapse could only be depicted with DWI [ 79 ].…”

“…In a recent study Giannarini et al described five patients with biochemical failure after RP and pelvic lymph node dissection in whom locoregional relapse could only be depicted with DWI [ 79 ]. Recent studies demonstrate the usefulness of DWI technique as a valid toot in detecting local cancer recurrence after external beam radiation therapy [ 77 ] and after RP [ 78 ], even though these early experiences were based on a small number of patients.…”