Abstract:

Background: Prostate cancer is the second most common cancer in men worldwide and the second cause of cancer-related death. MRI became the method of choice for detection and staging of prostate cancer. Functional MRI sequences such as DWI have the potential to provide information about the tumor microenvironment and angiogenesis and, hence, about the biologic aggressiveness of the tumor.

Aims: to compare the ADC value of prostatic carcinoma of the peripheral zone with that of normal contralateral prostate tissue and to study the correlation between |ADC value and Gleason score.

Patients and methods: This prospective study was done on 40 consecutive patients with biopsy proved (radical prostatectomy) prostatic carcinoma of the peripheral zone. Patients age were range of 50-75 years; the study was done in the MRI department of AL-Imamain AL-Kadhemain medical city, Baghdad/ Iraq during period from January 2017 to January 2018. MRI of the prostate was done using 1.5T scanner (MAGNETOM Area, SIEMENS, Germany) with the following sequences: axial, coronal and sagittal high-resolution T2w spin echo. Axial DWI sequence with b values of 50, 400, and 2000 s/mm2.Axial pre and post dynamic contrast enhanced MRI (DCE-MRI) sequence with gadolinium contrast agent.

Results: there was a highly significant decrease in ADC as PIRAD level increase (P value 0.0001) but there was no statistically significant difference in the mean ADC among the different PIRAD levels (P value 0.360).By comparing the ADC of each PIRAD level with the ADC of normal peripheral zone there was a highly significant difference in the mean ADC between the tumor and the normal prostatic tissue within each PIRAD level (P value 0.0001). The mean ADC of the tumor was significantly decreased as Gleason score increased.

Conclusion: ADC value is a valuable tool for non invasive assessment of prostate cancer. There is good correlation between ADC value, PIRAD level and the Gleason score.