Value of MRI diffusion weighted imaging in localization of prostate cancer with whole-mount step section pathology / 中华泌尿外科杂志

ABSTRACT

ObjectiveTo evaluate the value of MRI diffusion weighted imaging in localization of prostate cancer with whole-mount step section pathology.MethodsWe treated 36 patients using laparoscopic radical prostatectomy from Oct. 2009 to Jun. 2010. Patients who did not have an MRI/DWI examination or a surgical history of prostate and previous hormonal therapy were excluded, leaving 19 patients in our study. We analyzed the MRI and DWI collected before radical prostetectomy surgey and the post-surgery step section pathology made by the whole mount technique. The prostatic gland was divided into six sections. Two doctors read the MRI/DWI without knowing the patients' information and scored, using a 5 point scale, for each section. The tissue was graded according to the following scale 1-definitely no cancer, 2-probably no cancer, 3-possible cancer, 4-probable cancer and 5-definite cancer. When the average score ≥4 the region was assumed to be the prostate cancer region by MRI or MRI/DWI.ResultsIn 19 patients with 114 regions, there were 48 (42％) prostate cancer regions approved by whole-mount step section pathologically.The number of prostate cancer regions was 15 (39％), 21 (55％) and 12 (32％) in base, mid and apex parts respectively. The sensitivity and specificity of the MRI was 62.5％ and 69.7％. When considering DWI, the specificity and sensitivity was elevated to 79.1％ and 83.3％. As for the apex and mid parts, the sensitivities of MRI were a little bit low (46.7％ and 66.7％ ). But the sensitivities of localization of prostate cancer for the apex and mid of prostate were elevate to 73.3％ and 85.7％ respectively when DWI was also used.ConclusionsWith whole-mount step-section pathology, the combination of MRI and DWI can improve the sensitivity of MRI for localized diagnosis in prostate cancer, especially in apex and mid parts of the prostate.