The Accuracy of Biparametric Prostate MRI in the Pathway of Patients With Prostate Cancer

双参数前列腺磁共振成像在前列腺癌患者诊疗路径中的准确性

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Abstract

Background and objectives Prostate cancer is one of the most commonly diagnosed cancers, often presenting with mild or no symptoms unless it is locally advanced or has metastasized. Given the increasing incidence of prostate cancer and its potential for severe progression, developing strategies for early detection and effective management is crucial to reduce its impact on both the population and the healthcare system. Established diagnostic methods for prostate cancer include prostate-specific antigen testing, digital rectal examination, ultrasound-guided biopsy, and histological analysis. MRI plays a key role in localizing prostate cancer, assessing its extent, and predicting tumor aggressiveness. Both multiparametric MRI and biparametric MRI (bpMRI) are currently in use. This study aims to evaluate the role and accuracy of bpMRI in patients with prostate cancer, particularly for diagnosing clinically significant cancer, assessing its extent, and monitoring patients post-treatment for early recurrence. Materials and methods This retrospective study analyzed data from 50 patients who underwent MRI examinations. The prostate lesions identified in these patients were later pathologically confirmed as prostate cancer through biopsy or surgical resection. The study aimed to evaluate the accuracy of T2-weighted imaging (T2WI), diffusion-weighted imaging, apparent diffusion coefficient (ADC) maps, and T1-weighted imaging (T1WI). Results On T2WI, the lesions appeared hypointense in 46 (92%) of the 50 cases. Diffusion restriction was observed on DWI and ADC map sequences in 43 (86%) of the cases. On T1WI, cancerous lesions were isointense in 47 (94%) cases and moderately hyperintense in three (6%) cases, particularly in lesions larger than 8 mm in diameter. Conclusions The findings of this study confirm the high accuracy of T2WI in diagnosing malignant prostate lesions. The MRI information obtained is crucial for treatment planning and for assessing patient prognosis.

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