Role of diffusion weighted MR imaging in differentiating benign from malignant prostate lesions

Background: The purpose of the study was to determine the diagnostic accuracy of diffusion weighted MR imaging and to propose a cut off ADC value in differentiating benign from malignant prostatic lesions considering histopathology as gold standard.Methods: It is a descriptive type of observational study done on 40 patients with clinical suspicion of prostate carcinoma and elevated PSA level more than 4ng/ml. The patients underwent Multiparametric prostate MRI and ADC values were calculated using ADC maps.Results: Of the 40 cases included in the study histopathology revealed a diagnosis of abscess (1), chronic prostatitis (2), BPH with chronic prostatitis (4), BPH (12), and malignancy (21). The mean and standard deviation (SD) of ADC values for the abscess (0.59), CP (0.83+0.16), BPH with CP (0.94+0.22), BPH (1.14+0.14) and malignancy (0.72+0.15) (x10-3mm2/s) were found in our study. The mean ADC value of malignant lesion was lower (0.727+0.149) as compare to benign lesion (1.034+0.216) and this difference was found to be statistically significant with p<0.001. By using ROC curve, ADC cut off value was calculated as 0.92 x 10-3mm2/s and sensitivity, specificity at this cut off value of ADC were 95.24% and 73.68% respectively. The PPV, NPV, diagnostic accuracy of at this cut off value of ADC were 80%, 93.33%, 85% respectively.Conclusions: Our study shows that DWI with ADC calculation helps in differentiation of Benign from Malignant prostatic lesions with high accuracy and this quantitative analysis should be incorporated in routine MRI evaluation of prostatic lesions

Giant Splenic Cyst: A Case Report And Consolidated Review Of Literature With Radiographic Features

The spleen is a relative stranger to the world of cysts and tumors, which when discovered, are often incidental findings in otherwise asymptomatic individuals. Splenic cysts are far more common than solid lesions and can include congenital, inflammatory, vascular, post-traumatic, neoplastic, and parasitic types. Parasitic cysts in the spleen are usually caused by the larval forms of Echinococcus, a cyclophyllid tapeworm. However rare, it is important to recognize the splenic presentation of this uncommon entity to prevent life-threatening complications like anaphylaxis induced by traumatic or spontaneous cyst rupture. We report here a case of a giant dumbbell-shaped splenic cyst. Hydatid disease of the spleen should be considered in the differential of every patient presenting with a cystic lesion of the spleen in the endemic areas until proven otherwise.