Objective:

Prostate cancer is the third leading cause of death and is the most common genitourinary malignancy in men. The aim of this study is to evaluate the contribution of diffusion-weighted imaging (DWI) in the diagnosis of peripheral zone located prostate carcinoma while performing endorectal surface coil magnetic resonance imagining (MRI).

Methods:

This study was performed retrospectively between 2010-2011 to 38 male patients who have 66.8 years age average (between 49-85), according to their prostate MRI findings with an endorectal surface coil correlation with clinical findings.

Results:

In this study all of the patients’ prostate carcinoma diagnosis were confirmed histopathologically. The mean Gleason score was 7 (4+3). In routine sequences of MRI assessment, we found an increase of the prostate diamaters, generally homogenous SI in the central zone and heterogenous SI in the peripheral zone. On T1 WI there was high SI because of pervious core biopsy and secondary hemorrhage, on T2 WI there was heterogenous SI. This area was heterogenous on contrast enhanced series because of different hemorrhagic elements. On DWI series there was restricted diffusion at this site and hypointensity on ADC mapping. After ADC mapping of our patients, mean ADC values were measured as 0.98±0.36 x10^-3 mm²/s.

Conclusion:

Currently, prostate MRI with an endorectal surface coil is recommended if cancer is suspected despite negative biopsy findings and for local staging of the cancer. However, a prebiopsy MRI has not been indicated for the detection and localization of cancer. DWI with ADC measurement is useful to distinguish between benign and malignant lesions. Compared with T2WI, the addition of an ADC map improves the diagnostic performance of MRI in prostate cancer detection and localization. Our results showed that DWI improves the diagnosis and detection of prostate carcinoma located in the peripheral zone.

Keywords: Prostate carcinoma, endorectal coil, MRI, DWI-ADC