Effects of Dynamic Contrast Enhancement on Transition Zone Prostate Cancer in Prostate Imaging Reporting and Data System Version 2.1

BACKGROUND: The aim of the study was to analyse the effects of dynamic contrast enhanced (DCE)-MRI on transitional-zone prostate cancer (tzPCa) and clinically significant transitional-zone prostate cancer (cs-tzPCa) in Prostate Imaging Reporting and Data System (PI-RADS) Version 2.1. PATIENTS AND METHODS: The diagnostic efficiencies of T2-weighted imaging (T2WI) + diffusion-weighted imaging (DWI), T2WI + dynamic contrast-enhancement (DCE), and T2WI + DWI + DCE in tzPCa and cs-tzPCa were compared using the score of ≥ 4 as the positive threshold and prostate biopsy as the reference standard. RESULTS: A total of 425 prostate cases were included in the study: 203 cases in the tzPCa group, and 146 in the cs-tzPCa group. The three sequence combinations had the similar areas under the curves in diagnosing tzPCa and cs-tzPCa (all P < 0.05). The sensitivity of T2WI + DCE and T2WI + DWI + DCE (84.7% and 85.7% for tzPCa; 88.4% and 89.7% for cs-tzPCa, respectively) in diagnosing tzPCa and cs-tzPCa was significantly greater than that of T2WI + DWI (79.3% for tzPCa; 82.9% for cs-tzPCa). The specificity of T2WI + DWI (86.5% for tzPCa; 74.9% for cs-tzPCa) were significantly greater than those of T2WI + DCE and T2WI + DWI + DCE (68.0% and 68.5% for tzPCa; 59.1% and 59.5% for cs-tzPCa, respectively) (all P > 0.05). The diagnostic efficacies of T2WI + DCE and T2WI + DWI + DCE had no significant differences (all P < 0.05). CONCLUSIONS: DCE can improve the sensitivity of diagnosis for tzPCa and cs-tzPCa, and it is useful for small PCa lesion diagnosis.