Objective: The objectives of the study were to analyze the apparent diffusion coefficient (ADC), ktrans, kep metrics in dynamic contrast-enhanced multiparametric MRI (DCE-mpMRI) in biopsy proven cases of prostate cancer (PCa) and prostatitis and to establish "cut-off" values for various pharmacokinetic parameters that may distinguish PCa from chronic prostatitis.
Methods: A retrospective review of all cases of PCa and chronic prostatitis patients, who underwent DCE-mpMRI in our institute was done from July 2017 to January 2019. Mean ADC, ktrans , kep for lesion "L" (ADCL, ktrans L , kepL) and normal prostate tissue "N" (ADCN, ktrans N , kepN ,) were calculated for each region of interest. Different ratios ADC ratio (defined as ADCL/ ADCN), ktrans ratio (ktrans L/ ktrans N), kepratio (kepL/kepN) were calculated to differentiate PCa from chronic prostatitis.
Results: Total of biopsy proven 14 cases of PCa and 18 cases of chronic prostatitis were included in the study. For ktrans ratio, the optimal cut-off was at 1.49 units where sensitivity was 85.7%, specificity was 61.1 % and Youden's index was 0.468 %. Similarly, optimal cut-offs determined for kep lesion was 0.86 (sensitivity 85.7%, specificity 66.7%, J = 0.524) and for kep ratio was 1.34 units (sensitivity 78.6%, specificity 66.7%, J = 0.543).
Conclusion: DCE-mpMRI metrics could differentiate between PCa and chronic prostatitis with good specificity and sensitivity, while ProstateImaging Reporting and Data System v. 2 alone, did not differentiate between these patterns.
Advances in knowledge: ktrans ratio, kep lesion and kep ratio can differentiate PCa from chronic prostatitis.