Analysis of the Diagnostic Efficacy and Clinical Utility of Multiparametric MRI in Prostate Cancer Diagnosis.

Abstract

Objective: To evaluate the diagnostic efficacy and clinical relevance of multiparametric MRI (mpMRI) in detecting prostate cancer (PCA).

Methods: This retrospective study analyzed 64 patients with suspected PCA who underwent MRI and were pathologically diagnosed with either PCA (n=33) or benign prostatic lesions (BPL, n=31). Imaging characteristics were assessed using T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced MRI (DCE-MRI). DWI signal intensities at b=50 and b=800s/mm² and apparent diffusion coefficient (ADC) values were compared. Perfusion parameters, including Ktrans, Ve, and Kep, were also analyzed. Spearman correlation assessed associations between imaging parameters and PCA occurrence. Receiver operating characteristic (ROC) curves evaluated the diagnostic performance of each sequence and their combination.

Results: PCA lesions showed hypointensity on T2WI, hyperintensity on DWI, and type II/III curves on DCE-MRI. Signal intensities at b=50 and b=800s/mm² and ADC values were significantly lower in PCA than in BPL (P < 0.05), whereas Ktrans, Ve, and Kep were significantly higher (P < 0.05). Spearman analysis showed negative correlations between PCA occurrence and b=50, b=800 signal intensities and ADC (r = -0.547, -0.529, -0.601), and positive correlations with Ktrans, Ve, and Kep (r = 0.516, 0.538, 0.552; all P < 0.05). ROC analysis revealed AUCs of 0.834 (T2WI), 0.819 (DWI), 0.696 (DCE-MRI), and 0.902 (combined T2WI+DWI), with the combined approach yielding the highest diagnostic accuracy.

Conclusion: mpMRI parameters including DWI signal intensity, ADC, and DCE-MRI perfusion values are significantly associated with PCA. Combined application of T2WI and DWI improves diagnostic accuracy and may offer greater clinical value than individual sequences.