Comparing Multiparametric Magnetic Resonance Imaging findings to Histopathology for differentiating benign prostatic conditions from malignant prostate cancer

Abstract

The aim of this study is to assess the diagnostic performance of multiparametric magnetic resonance imaging (mpMRI) for benign prostatic conditions and prostate cancer (CaP) diagnosis, and to compare it with the histopathological results. A total of 74 male patients age 50 and older, who had elevated PSA and abnormal digital rectal examination (DRE) were included. mpMRI and transrectal ultrasound (TRUS) guided biopsy was performed on all participants. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were used in assessing the diagnostic accuracy of mpMRI. The results revealed high sensitivity (95.56%) and good specificity (82.76%) of mpMRI with a PPV of 89.58% and an NPV of 92.31%. The Cohen Kappa score of 0.798 revealed high level of agreement between mpMRI and histopathology. The study also revealed that mpMRI was able to accurately detect clinically significant prostate cancer (csPCa) and distinguish it from other non-cancerous prostate conditions like BPH and prostatitis. However, there were always false positives and false negatives, especially in cases where there was a benign mimic or low-grade tumour. Despite these drawbacks, the results indicate that mpMRI can be applied as a valid noninvasive diagnosis technology, and offer supplementary information to histopathology for better patient management. This work provides a solid basis for implementing the use of mpMRI in clinical practice for prostate cancer diagnosis and staging, which could be enhanced with the development of new and more sophisticated technologies like radiomics and machine learning.