Susceptibility Weighted Imaging: A New Tool in the Diagnosis of Prostate Cancer and Detection of Prostatic Calcification

Abstract

BackgroundSusceptibility weighted imaging (SWI) is a new MRI technique which has been proved very useful in the diagnosis of brain diseases, but few study was performed on its value in prostatic diseases. The aim of the present study was to investigate the value of SWI in distinguishing prostate cancer from benign prostatic hyperplasia and detecting prostatic calcification.Methodology/Principal Findings23 patients with prostate cancer and 53 patients with benign prostatic hyperplasia proved by prostate biopsy were scanned on a 3.0T MR and a 16-row CT scanner. High-resolution SWI, conventional MRI and CT were performed on all patients. The MRI and CT findings, especially SWI, were analyzed and compared. The analyses revealed that 19 out of 23 patients with prostate cancer presented hemorrhage within tumor area on SWI. However, in 53 patients with benign prostatic hyperplasia, hemorrhage was detected only in 1 patient in prostate by SWI. When comparing SWI, conventional MRI and CT in detecting prostate cancer hemorrhage, out of the 19 patients with prostate cancer who had prostatic hemorrhage detected by SWI, the prostatic hemorrhage was detected in only 7 patients by using conventional MRI, and none was detected by CT. In addition, CT demonstrated calcifications in 22 patients which were all detected by SWI whereas only 3 were detected by conventional MRI. Compared to CT, SWI showed 100% in the diagnostic sensitivity, specificity, accuracy, positive predictive value(PPV) and negative predictive value(NPV) in detecting calcifications in prostate but conventional MRI demonstrated 13.6% in sensitivity, 100% in specificity, 75% in accuracy, 100% in PPV and 74% in NPV.ConclusionsMore apparent prostate hemorrhages were detected on SWI than on conventional MRI or CT. SWI may provide valuable information for the differential diagnosis between prostate cancer and prostatic hyperplasia. Filtered phase images can identify prostatic calcifications as well as CT.

Prostate cancer research in China

“…Another study challenged conventional computed tomography and magnetic resonance imaging using susceptibility-weighted imaging. 26 Susceptibility-weighted imaging was demonstrated to detect a greater number of prostate haemorrhages than computed tomography and magnetic resonance imaging and was better able to distinguish PCa from benign prostatic hyperplasia. Novel imaging technologies can and likely will soon offer more accurate diagnoses as a result of rapid technological innovation, such as molecular imaging.…”

Imaging for Prostate Cancer

“…Bai et al used it for pre-biopsy differentiation of BPH and PC, as well as detection of calcifications. In 23 patients with post-MRI proven PC and 53 with BPH they were able to find much more hemorrhage in patients with PC (19 of 23 vs. 1 of 53) [5]. The authors suggested that the higher microvessel density in PC caused more bleedings than in BPH.…”

Diagnostic performance of susceptibility-weighted magnetic resonance imaging for the assessment of sub-coracoacromial spurs causing subacromial impingement syndrome

“…Due to phase artefacts, it has been challenging in the past to routinely extract this information. The development of SWMR has made it feasible to reliably detect calcific lesions in MRI due to their diamagnetic properties [13][14][15][16][17][18][19][20][21][22]. SWMR is based on the development of novel filtering techniques and enables the extraction of this information, which can be used for further characterization of tissues [13,14].…”

“…SWMR is based on the development of novel filtering techniques and enables the extraction of phase information, which can be used for further characterization of tissues [13,14]. Using the combination of magnitude and phase information, SWMR has made it feasible to detect calcific lesions in MRI due to their diamagnetic properties [13][14][15][16][17][18][19][20][21][22]. Different studies demonstrated the potential of SWMR for the characterization of neurological disorders or brain tumours and the differentiation of diamagnetic calcifications from paramagnetic intratumoral haemorrhage [15,21].…”

“…Different studies demonstrated the potential of SWMR for the characterization of neurological disorders or brain tumours and the differentiation of diamagnetic calcifications from paramagnetic intratumoral haemorrhage [15,21]. More recently, SWMR was used for the differentiation of benign and malignant prostate lesions [18]. SWMR is, however, not well investigated for the assessment of calcific lesions or bony structures in musculoskeletal diseases.…”