Affiliations: [a] Department of Diagnostic Imaging, Segamat Hospital, Segamat, Johor, Malaysia | [b] Department of Radiology, Universiti Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia
Correspondence:
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Corresponding author: M.Y. Siti Rohani, Department of Diagnostic Imaging, Segamat Hospital, 8, Jalan Genuang, Bandar Putra, 85000 Segamat, Johor, Malaysia. Tel.: +60 165 024 014; E-mail: [email protected].
Abstract: Objective: The aim of this study was to evaluate the role of diffusion-weighted imaging (DWI) and Apparent Diffusion Coefficient (ADC) MRI techniques in the detection and localization of prostate carcinoma in Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM). Materials and Methods: DWI (b value = 800 s/mm)2 and ADC at 3T were evaluated retrospectively in 78 male patients with suspicion of prostate cancer. The prostate MRI was evaluated after dividing each prostate gland into 6 sections (n= 462). Six sections were excluded as biopsy result came back as unsatisfactory. Minimum ADC values of each section in the peripheral zone were measured. The MRI finding was compared with biopsy result obtained from each section. Results: The mean minimum ADC values of malignant sextants were significantly lower than that of noncancerous tissue, with a significant negative correlation between the ADC value and the Gleason score. The sensitivity and specificity for DWI + ADC were 52.14% and 93.48% respectively. There is significant difference between malignant and benign ADC value (p= 0.0000). The area under the receiver operating characteristic curve for the detection and localization of prostate cancer within the peripheral zone is 0.788 for ADC, which represents a fair to good test. The cut off ADC value between benign and malignant tissue is 1174.5 mm2/s at 93.48% specificity. Conclusion: The current DWI and ADC technique used in our center is very specific and is valuable in detecting, localizing, grading prostate carcinoma and guiding targeted biopsy, with areas of lowest ADC values can indicate the regions to be biopsied.
