Objective:

The main aim is to evaluate the value of dynamic contrast-enhanced (DCE) imaging in multi-parametric prostate MRI (mpMRI) for the detection and staging of prostate cancer in comparison with T2W and DWI images alone in biparametric MRI (bpMRI), in treatment naïve patients.

Methods:

One hundred consecutive patients who underwent a prostate MRI at our institution from June-August 2017, as well as a systematic ultrasound-guided prostate biopsy or prostatectomy, were included. Strictly following the PIRADSv2, the MRI studies were independently interpreted by a body radiologist and a body-imaging fellow on two different occasions 8-10 weeks apart. Initially, with all mpMRI sequences and then without the DCE sequence (bpMRI). The readers were blinded to the clinical information. Ethics approval was obtained.

Results/Discussion:

One hundred treatment-naïve patients were included (median age 64, age range 48-81, mean PSA 10.3). There was excellent intra-observer agreement of the mpMRI versus bpMRI for both readers [Cohen’s Kappa (k) 0.88-0.86] and very good inter-observer agreement (k=0.74 for mpMRI and 0.76 for bpMRI). The sensitivity and specificity did not significantly change between the multi-parametric and bi-parametric MRI (Sensitivity 91.7% and 90%, Specificity of 85.5% and 85% for mpMRI and bpMRI, respectively).

Conclusion:

Prostate MRI without DCE (bpMRI) is of comparable diagnostic accuracy to mpMRI in treatment-naïve patients. Performing prostate MRI without DCE (bpMRI) will reduce acquisition time, decrease cost and potentially improve patient safety.

Prospective Evaluation of the Value of Dynamic Contrast-Enhanced (DCE) Imaging for Prostate Cancer Detection and Staging with Pathology Correlation