Multi-Parametric Evaluation of Prostate Cancer on MRI

Main Article Content

Summrah Javed
M. Mukkaram Zafar
Shakeela Rasheed
Syed Asadullah Shah
Ahmed Imtiaz
Muhammad Umar
Samiya Saeed


Background: Prostate cancer is the most common malignancy among men globally and the second leading cause of cancer-related deaths. The increasing prevalence, particularly in aging populations, underscores the urgent need for accurate diagnostic tools to facilitate early detection, precise staging, and effective management. Traditional diagnostic methods, including Digital Rectal Examination (DRE) and Prostate-Specific Antigen (PSA) testing, have limitations in sensitivity and specificity, leading to unnecessary procedures and missed diagnoses.

Objective: This study aims to evaluate the efficacy of multiparametric Magnetic Resonance Imaging (mpMRI) in the diagnosis and staging of prostate cancer, comparing its accuracy with conventional diagnostic methods and examining its role in improving patient outcomes.

Methods: A retrospective descriptive cross-sectional study was conducted at the Diagnostic Center of Combined Military Hospital, Lahore, from January 2021 to June 2023. Sixty male patients suspected of having prostate cancer, based on elevated PSA levels (>10 ng/mL) or clinical symptoms, were included. mpMRI scans were performed using a Siemens Avanto MRI Machine 1.5T, incorporating T2-weighted imaging, Diffusion-Weighted Imaging (DWI), and Dynamic Contrast-Enhanced (DCE) MRI. The Prostate Imaging Reporting and Data System (PI-RADS) was employed for interpretation. Statistical analysis was conducted using SPSS 26.0, with chi-square tests applied to assess the association between mpMRI findings and prostate cancer diagnosis.

Results: mpMRI identified prostate cancer with a sensitivity of 85% and specificity of 88.3%, as evidenced by abnormal MRI findings in 53 out of 60 patients. Elevated PSA levels were confirmed in 90% of the cases. T2-weighted imaging demonstrated hypointensity in the peripheral zone in 70% of patients, while DWI and ADC mapping showed restricted diffusion in 85% of the cases. DCE-MRI revealed post-contrast enhancement in 40% of the participants. The PI-RADS scoring system effectively graded the severity of prostate lesions, with 38.3% of cases categorized as PI-RADS IV.

Conclusion: Multiparametric MRI significantly enhances the accuracy of prostate cancer diagnosis and staging, surpassing traditional diagnostic methods in sensitivity and specificity. By providing detailed anatomical and functional information, mpMRI facilitates early detection, accurate localization, and appropriate management of prostate cancer, potentially improving patient outcomes.

Article Details

How to Cite
Javed, S., Zafar, M. M., Rasheed , S., Shah , S. A., Imtiaz, A., Umar, M., & Saeed, S. (2024). Multi-Parametric Evaluation of Prostate Cancer on MRI. Journal of Health and Rehabilitation Research, 4(1), 371–376.
Author Biographies

Summrah Javed, CMH Medical & Dental College Lahore Pakistan.

School of Allied Health Sciences.

M. Mukkaram Zafar, CMH Medical & Dental College Lahore Pakistan.

School of Allied Health Sciences.

Syed Asadullah Shah , CMH Medical & Dental College Lahore Pakistan.

School of Allied Health Sciences.

Ahmed Imtiaz, CMH Medical & Dental College Lahore Pakistan.

School of Allied Health Sciences.

Muhammad Umar, CMH Medical & Dental College Lahore Pakistan.

School of Allied Health Sciences.

Samiya Saeed, CMH Medical & Dental College Lahore Pakistan.

School of Allied Health Sciences.


Siddiqui K, Magsi K, Iqbal J, Ahmed A, Fazal A, Siddiqui I, et al. To Determine the Diagnostic Accuracy of Diffusion-Weighted Imaging in the Diagnosis of Prostate Carcinoma Taking Histopathology As the Gold Standard. 2021;13(11).

Maurer MH, Heverhagen JTJTa, urology. Diffusion weighted imaging of the prostate—principles, application, and advances. 2017;6(3):490.

Teoh JY, Hirai HW, Ho JM, Chan FC, Tsoi KK, Ng CFJPo. Global incidence of prostate cancer in developing and developed countries with changing age structures. 2019;14(10):e0221775.

Wong MC, Goggins WB, Wang HH, Fung FD, Leung C, Wong SY, et al. Global incidence and mortality for prostate cancer: analysis of temporal patterns and trends in 36 countries. 2016;70(5):862-74.

Łuczyńska E, Heinze-Paluchowska S, Domalik A, Ćwierz A, Kasperkiewicz H, Blecharz P, et al. The utility of diffusion weighted imaging (DWI) using apparent diffusion coefficient (ADC) values in discriminating between prostate cancer and normal tissue. 2014;79:450.

Choi YJ, Kim JK, Kim N, Kim KW, Choi EK, Cho K-SJR. Functional MR imaging of prostate cancer. 2007;27(1):63-75.

Stabile A, Giganti F, Rosenkrantz AB, Taneja SS, Villeirs G, Gill IS, et al. Multiparametric MRI for prostate cancer diagnosis: current status and future directions. 2020;17(1):41-61.

Sun Y, Reynolds HM, Parameswaran B, Wraith D, Finnegan ME, Williams S, et al. Multiparametric MRI and radiomics in prostate cancer: a review. 2019;42(1):3-25.

Bratan F, Niaf E, Melodelima C, Chesnais AL, Souchon R, Mège-Lechevallier F, et al. Influence of imaging and histological factors on prostate cancer detection and localisation on multiparametric MRI: a prospective study. 2013;23(7):2019-29.

Turkbey B, Choyke PLJCoiu. Multiparametric MRI and prostate cancer diagnosis and risk stratification. 2012;22(4):310.

Sherrer RL, Glaser ZA, Gordetsky JB, Nix JW, Porter KK, Rais-Bahrami SJPc, et al. Comparison of biparametric MRI to full multiparametric MRI for detection of clinically significant prostate cancer. 2019;22(2):331-6.

Wegelin O, van Melick HH, Hooft L, Bosch JR, Reitsma HB, Barentsz JO, et al. Comparing three different techniques for magnetic resonance imaging-targeted prostate biopsies: a systematic review of in-bore versus magnetic resonance imaging-transrectal ultrasound fusion versus cognitive registration. Is there a preferred technique? 2017;71(4):517-31.

Radtke JP, Teber D, Hohenfellner M, Hadaschik BAJTa, urology. The current and future role of magnetic resonance imaging in prostate cancer detection and management. 2015;4(3):326.

Ingole SM, Mehta RU, Kazi ZN, Bhuyar RVJIJoR, Imaging. Multiparametric Magnetic Resonance Imaging in Evaluation of Clinically Significant Prostate Cancer. 2021;31(01):065-77.

Naji L, Randhawa H, Sohani Z, Dennis B, Lautenbach D, Kavanagh O, et al. Digital rectal examination for prostate cancer screening in primary care: a systematic review and meta-analysis. 2018;16(2):149-54.

Catalona WJ, Smith DS, Ratliff TL, Dodds KM, Coplen DE, Yuan JJ, et al. Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. 1991;324(17):1156-61.

Cuocolo R, Stanzione A, Ponsiglione A, Romeo V, Verde F, Creta M, et al. Clinically significant prostate cancer detection on MRI: A radiomic shape features study. 2019;116:144-9.

Lee HY, Lee HJ, Byun S-S, Lee SE, Hong SK, Kim SHJKjor. Classification of focal prostatic lesions on transrectal ultrasound (TRUS) and the accuracy of TRUS to diagnose prostate cancer. 2009;10(3):244-51.

Arif M, Schoots IG, Castillo Tovar J, Bangma CH, Krestin GP, Roobol MJ, et al. Clinically significant prostate cancer detection and segmentation in low-risk patients using a convolutional neural network on multi-parametric MRI. 2020;30:6582-92.

Turkbey B, Brown AM, Sankineni S, Wood BJ, Pinto PA, Choyke PLJCacjfc. Multiparametric prostate magnetic resonance imaging in the evaluation of prostate cancer. 2016;66(4):326-36.

Kim JY, Kim SH, Kim YH, Lee HJ, Kim MJ, Choi MSJR. Low-risk prostate cancer: the accuracy of multiparametric MR imaging for detection. 2014;271(2):435-44.

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