Purpose To determine the prostate cancer detection rate of multi-parametric (MP) MRI at 3T. Precise one to one histopathologic correlation with MRI was possible using prostate MRI based custom-printed specimen molds following radical prostatectomy. Materials and methods This IRB approved prospective study included forty-five patients (mean age 60.2 years, range 49–75 years) with a mean PSA of 6.37ng/mL (range 2.3–23.7ng/mL), who had biopsy proven prostate cancer (mean Gleason score of 6.7; range 6 to 9). Prior to prostatectomy, all patients underwent prostate MRI on a 3T scanner which included tri-plane T2 weighted MRI, apparent diffusion coefficient maps of diffusion weighted MRI, dynamic contrast enhanced MRI, and spectroscopy.. The prostate specimen was whole mount sectioned in the mold allowing geometric alignment to MRI. Tumors were mapped on MRI and histopathology.. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of MRI for cancer detection were calculated. Additionally, the effects of tumor size and Gleason score on sensitivity of MP-MRI were evaluated. Results PPV of MP-MRI to detect prostate cancer was 98%, 98%, and 100% in overall prostate, peripheral zone, and central gland, respectively. Sensitivities of MRI sequences were higher for tumors >5mm in diameter, as well as for tumors with higher Gleason scores (>7) (p<0.05). Conclusion Prostate MRI at 3T allows for the detection of prostate cancer. A multi-parametric approach increases the predictive power of MRI for diagnosis. In this study, accurate correlation between MP-MRI and histopathology was obtained by the patient specific MRI-based mold technique.

Purpose:To investigate whether apparent diffusion coefficients (ADCs) derived from diffusion-weighted (DW) magnetic resonance (MR) imaging at 3 T correlate with the clinical risk of prostate cancer in patients with tumors that are visible on MR images, with MR imaging/transrectal ultrasonography (US) fusion-guided biopsy as a reference. Materials and Methods:Forty-eight consecutive patients (median age, 60 years; median serum prostate-specifi c antigen value, 6.3 ng/mL) who underwent DW imaging during 3-T MR imaging with an endorectal coil were included in this retrospective institutional review board-approved study, and informed consent was obtained from each patient. Patients underwent targeted MR imaging/transrectal US fusion-guided prostate biopsy. Mean ADCs of cancerous target tumors were correlated with Gleason and D'Amico clinical risk scores. The true risk group rate and predictive value of the mean ADC for classifying a tumor by its D'Amico clinical risk score was determined by using linear discriminant and receiver operating characteristic analyses. Results:A signifi cant negative correlation was found between mean ADCs of tumors in the peripheral zone and their Gleason scores ( P = .003; Spearman r = 2 0.60) and D'Amico clinical risk scores ( P , .0001; Spearman r = 2 0.69). ADC was found to distinguish tumors in the peripheral zone with intermediate to high clinical risk from those with low clinical risk with a correct classifi cation rate of 0.73. Conclusion:There

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