Diagnostic value of trans rectal ultra-sonography in comparison with MR imaging in detection and characterization of prostatic lesions

Document Type : Original Article

Authors

1 Department of, Radiology, sohag Faculty of Medicine.

2 Department, of Radiology, sohag Faculty of Medicine.

3 Department, of Urology, sohag Faculty of Medicine.

Abstract

Aim:To evaluate the diagnostic accuracy of MRI techniques in detection and characterization of different prostatic lesions in comparison with TRUS.
Patient and Methods:This prospective study include TRUS and MRI prostate of 30 adult male patients presented by different prostatic lesions obtained by using 1.5Tmachine, using pelvic phased array coil and/or endorectal coil. Pulse sequences include conventional (T1W&T2W) , MR spectroscopic imaging (MRSI), diffusion-weighted imaging (DWI) and/or dynamic contrast-enhanced MRI (DCE-MRI). The mp MRI results are correlated with TRUS results and histopathological reports obtained after TRUS biopsies
Results: It was found that MRIhas 100%sensitivity  ,53%specificity ,68.2% positive predictive value ,100% negative predictive value  and 76.7 % overall accuracy formalignant prostatic lesions diagnosis compared with histopathological findings. BUT TRUS has 40%sensitivity  , 53.3 %specificity ,46.2% positive predictive value ,47.1% negative predictive value  and 46.8 % overall accuracy for malignant prostatic lesions diagnosis compared with histopathological findings
ConclusionThe currently used diagnostic tools are digital rectal examination; serum prostate-specific antigen (PSA), a nonspecific blood test; and Trans rectal ultrasound (TRUS)–guided biopsy, a standardized but untargeted method. Because of the limitations of these available diagnostic tools, advances in MRI techniques show potential for improving the diagnostic accuracy of MRI for prostatic lesions detection. A recently developed Multiparametric MRI approach that combines anatomic T2-weighted imaging with functional data appears to be one of the most promising techniques for prostatic lesions detection

References

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