Diagnostic Efficacy of Transrectal Ultrasound vs Magnetic Resonance Imaging in the Diagnosis of Carcinoma Prostate: A Cross-sectional Study

Abstract

Introduction: The high incidence and increasing awareness of prostate cancer, along with ongoing development of new and improved treatment methods have generated considerable need for imaging techniques that allow for accurate detection and staging of tumour prior to treatment. Aim: To compare the findings of Transrectal Ultrasound (TRUS) and Magnetic Resonance Imaging (MRI) in the diagnosis and localisation of carcinoma prostate. Materials and Methods: This cross-sectional study was conducted in the Department of Radiodiagnosis, Mysore Medical College, Mysore, Karnataka, India from April 2018 to June 2019. This study included 43 male patients, with age ranging from 49 to 76 years. They underwent TRUS, MRI and TRUS guided 12- core biopsies after being suspected with prostate cancer based on high Prostate Specific Antigen (PSA) values (greater than 4.0 ng/mL) or abnormal Digital Rectal Examination (DRE) findings. A cross table was used to compare the histopathology results, TRUS and MRI findings, from which sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) were calculated. Results: Total of 43 male patients were included with mean age of 64.8 years. The sensitivity, specificity, PPV and NPV of TRUS for detection of malignancy was 69.70, 80, 92 and 44.44 respectively and for MRI, it was 87.88%, 70%, 90.63% and 63.64% respectively. In addition, MRI detected lymphadenopathy in three patients and skeletal metastasis in four patients. Conclusion: MRI can improve the false negative biopsies resulting due to the inability of TRUS in the detection of abnormal areas, by showing the exact area of abnormality.