Original Articles
The role of magnetic resonance imaging (MRI) in prostate cancer diagnosis and its correlation with transrectal ultrasound guided BIOPSY (TRUS) | |
Dr. Kshitij Sharma, Dr. Jeevan Prakash, Dr. Aqra Ali | |
Aim: The objective of this research is to demonstrate the diagnostic efficacy of magnetic resonance imaging (MRI) using various parameters to assess prostatic tumors, specifically in distinguishing benign from malignant prostatic lesions. Materials and Method: Twenty consecutive male patients, with a mean age of 65 years and ages ranging from 50 to 80 years, were enrolled in this prospective study at the outset. These patients were selected based on the presence of various prostatic lesions, a prostate-specific antigen (PSA) level exceeding 4 ng/dL, or a hard nodule detected via digital rectal examination. Magnetic resonance imaging was utilized to evaluate these lesions, and the resulting histopathological data were correlated with the TRUS guided biopsy findings. Result: Twenty patients who presented with urological symptoms (dysuria, frequency, and urinary retention) were referred from urological outpatient clinics. The investigation was conducted using ultrasonography, conventional magnetic resonance, diffusion weighted images and MR spectroscopy on the patients; histopathological data were correlated with these findings. Conventional MRI has a moderate sensitivity of 81.8% and a low specificity of 37.3% in detecting prostate cancer, according to this study. By combining dynamic contrast enhanced, diffusion-weighted, and MR spectroscopic imaging with mpMRI, it is possible to distinguish between benign and malignant lesions in the prostate zone with a sensitivity of one hundred percent and a specificity of ninety-six percent. Conclusion: For a conclusive diagnosis of prostate cancer, trans-rectal ultrasound biopsy is the benchmark. Nevertheless, TRUS guided biopsy exhibits a notable sampling error, potentially overlooking as many as 30% of malignancies. Furthermore, it may underestimate the Gleason grade, particularly in the case of tumors situated anteriorly. It could potentially result in a heightened incidence of complications. MRI plays a crucial function in enhancing the safety of the diagnostic process. It can also assist in the planning of radiation therapy or surgery, as well as staging. Despite its extensive application in diagnosis due to its exceptional soft tissue resolution, T2W MRI exhibits suboptimal accuracy when it comes to the detection and localization of prostate cancer. Diagnostic efficacy is enhanced when multiparametric MRI techniques—MR spectroscopy, dynamic contrast enhanced imaging, and diffusion weighted imaging—are incorporated into a software application. |
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