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Role of diffusion-weighted magnetic resonance imaging in prostate cancer evaluation

Ruolo della risonanza magnetica con imaging di diffusione nella valutazione del carcinoma prostatico

  • Urogenital Radiology / Radiologia Uro-Genitale
  • Published:
La radiologia medica Aims and scope Submit manuscript

Abstract

Purpose

The authors analysed the role of diffusion-weighted imaging (DWI) as an additional tool in magnetic resonance (MR) evaluation of prostate cancer.

Materials and methods

Forty-one patients with suspected prostate cancer underwent MR imaging (1.5 Tesla). A DWI sequence was added to the standard morphological protocol, with a maximum b value of 1,000 s/mm2. Diffusion maps were obtained, and the apparent diffusion coefficient (ADC) was calculated by drawing a region of interest (ROI) over healthy tissue and areas suspicious for malignancy. Histology was considered the gold standard.

Results

The areas correctly classified by MR imaging (42/51) had a low signal intensity on T2-weighted imaging and low ADC value (0.99±0.15 mm2/s; p<0.01) compared with the healthy peripheral zone (PZ) (1.73±0.27 mm2/s; p<0.01). Nine areas classified as suspicious for malignancy on T2-weighted sequences showed high ADC (1.44±0.06 mm2/s; p<0.01) and were confirmed to be disease free by subsequent histological examination. The accuracy of morphofunctional MR imaging was 81.6% compared with 73.7% of the morphological analysis alone.

Conclusions

The addition of DWI to the standard protocol increases the overall diagnostic performance of MR imaging in detecting prostatic cancer. Thus, DWI can help the clinician determine the most appropriate management strategy for the patient.

Riassunto

Obiettivo

Scopo del presente lavoro è stato valutare il ruolo delle sequenze pesate in diffusione (DWI) come strumento addizionale nello studio del carcinoma prostatico in risonanza magnetica (RM).

Materiali e metodi

Quarantuno pazienti con sospetto di neoplasia prostatica sono stati sottoposti a RM (1,5 T). Al protocollo morfologico è stata aggiunta la sequenza single shot (SSh)-DWI sul piano assiale con valore massimo di b pari a 1000 s/mm2. Sono state ricostruite le mappe di diffusione ed il coefficiente di diffusione apparente (ADC) è stato calcolato posizionando le regioni di interesse (ROI) su tessuto sospetto e tessuto sano. L’esame istologico finale è stato considerato il gold standard.

Risultati

Le aree prostatiche correttamente identificate alla valutazione RM come sospette (42 su 51) hanno mostrato basso segnale nelle sequenze T2 pesate ed il corrispondente ADC è risultato statisticamente più basso (0,99±0,15 mm2/s; p<0,01) rispetto al tessuto nella regione periferica sana (1,73±0,27 mm2/s; p<0,01). Nove aree sospette alle sequenze T2 hanno mostrato ADC non tipico per localizzazione cancerose (1,44±0,06 mm2/s; p<0,01): l’esame istologico ha confermato i risultati della DWI. L’accuratezza globale dell’esame RM anatomo-funzionale è stata di 81,6%, più alta rispetto alla sola valutazione morfologica (73,7%).

Conclusioni

Includere la sequenza DWI nel protocollo RM standard migliora la performance diagnostica globale e può aiutare il clinico nel corretto management del paziente.

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Authors and Affiliations

  1. Dipartimento dei Servizi Diagnostici e per Immagine, Azienda Ospedaliero-Universitaria Policlinico di Modena, Università degli Studi di Modena e Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy

    D. Rinaldi, F. Fiocchi, G. Ligabue & P. Torricelli

  2. Struttura Complessa di Urologia, Azienda Ospedaliero-Universitaria Policlinico di Modena, Via del Pozzo 71, 41124, Modena, Italy

    G. Bianchi

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  1. D. Rinaldi
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  2. F. Fiocchi
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  3. G. Ligabue
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  4. G. Bianchi
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  5. P. Torricelli
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Correspondence to D. Rinaldi.

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Rinaldi, D., Fiocchi, F., Ligabue, G. et al. Role of diffusion-weighted magnetic resonance imaging in prostate cancer evaluation. Radiol med 117, 1429–1440 (2012). https://doi.org/10.1007/s11547-012-0832-8

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  • DOI: https://doi.org/10.1007/s11547-012-0832-8

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