Acosta-Falomir MJ, Angulo-Lozano JC, Sanchez-Musi LF, Soria Céspedes D, Fernández de Lara Barrera Y. Detection of High-Grade Prostate Cancer With a Super High B-value (4000 s/mm2) in Diffusion-Weighted Imaging Sequences by Magnetic Resonance Imaging.
Cureus 2022;
14:e22807. [PMID:
35399424 PMCID:
PMC8980248 DOI:
10.7759/cureus.22807]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction: High-grade adenocarcinoma of the prostate tends to have denser glandular structures and a prominent desmoplastic reaction, which could be detected by magnetic resonance imaging (MRI) with a super-high b-value in diffusion-weighted imaging (DWI) sequence, to differentiate it from low-grade carcinomas.
Objective: To evaluate the diagnostic validity of the diffusion sequence with values of b4000 s/mm2 for the diagnosis of high-grade prostate cancer (Gleason score ≥ 7).
Materials and methods: It is a retrospective analytical study of male patients who have undergone a prostate biopsy and count with a prostate MRI with a DWI sequence of a super-high b-value (4000 s/mm2).
Results: The sensitivity of the diffusion sequence with b4000 s/mm2 values to classify as positive for prostate cancer was 57.14% as compared to biopsy. The specificity of the diffusion sequence with b4000 s/mm2 values classifying patients with prostate carcinoma as negative was 84.62%. The probability that the diffusion sequence with b4000 s/mm2 values classifies patients with prostate cancer was 80%. The probability that the diffusion sequence with b4000 s/mm2 values does not classify patients with prostate cancer was 64.71%. The proportion of patients adequately classified with prostate cancer using the diffusion sequence with b4000 s/mm2 values was 70.37%.
Conclusions: The study shows that using the diffusion sequence with values of b4000 s/mm2 is an optimal value that serves as a tool to be able to decant those high-risk carcinomas with those of low risk; however, it is not a definitive method of diagnosis that could replace the performance of a biopsy. Since the study sample was limited, these results cannot be interpreted as reliable for diagnosing high-grade prostate cancer and should encourage future studies on a larger scale population to obtain significant evidence for a non-invasive diagnostic tool with a better cost-benefit for the patient.
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