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Diffusion-Weighted Magnetic Resonance Imaging in Differential Diagnosis of Prostatic Pathology

Sibel Çaglar Atacan, Deniz Çebi Olgun, Ebru Yılmaz, Sinharib Citgez, Ayhan Yılmaz

(Department of Radiology, Ministry of Justice, Council of Forensic Medicine, Istanbul, Turkey)

Med Sci Rev 2015; 2:1-7

DOI: 10.12659/MSRev.893206

Published: 2015-01-19

Abstract: Background: The aim of this study was to analyze the contribution of calculated coefficient diffusion values (ADC) using diffusion weighted magnetic resonance scanning to differentiate prostatic pathologies with diffusion-weighted signal characteristics and ADC values in addition to signal characteristics of conventional sequences without IV contrast administration, enlighten the route for prostate biopsy, and to minimize false negativity.
Material and Methods: A total of 92 patients referred by our urology clinic were included in the study. All patients had digital rectal examination findings and serum prostate-specific antigen (PSA) values. Magnetic resonance imaging (MRI) was performed with 1.5 T system (Magnetom Avanto, Siemens; Erlangen, Germany) before TRUS-guided prostate biopsy. In addition to conventional sequences, diffusion-weighted magnetic resonance sequences were applied. Diffusion-weighted scanning and ADC mapping were produced with 3 different b-values (b=0, b=500, b=1000 s/mm2) and diffusion-sensitive gradients were applied with single shot echo-planar spin echography at 1.5 Tesla magnetic resonance component on axial plan.
Results: Ninety-two patients underwent TRUS-guided prostate biopsy; malignant and benign lesions were reported by pathological analysis for 38 and 54 patients, respectively. ADC measurements average (ADC value) was 0.844 mm2/s for malignant tissues and 1.427 mm2/s for benign tissues. This indicates that benign lesion average ADC value is significantly higher than malignant lesions (p<0.001).
Conclusions: Remarkable results have been obtained to distinguish benign and malignant prostate lesions by using diffusion-weighted magnetic resonance scanning and quantitative ADC measurement.

Keywords: Diffusion Magnetic Resonance Imaging, Prostate-Specific Antigen, Prostatic Neoplasms