Title: MRI in Diagnosis of Prostate Carcinoma
Authors: Dr Mohammed Ameer Ali Khan Afrose MBBS (MD Radiology), Dr Yuefan Gu MBBS (MD Radiology), Dr Junkang Shen
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.67
Abstract
Introduction
Carcinoma of Prostrate is a commonly diagnosed tumour in males that represents a broad spectrum of severity, ranging from asymptomatic to highly lethal. The utilisation of prostate-specific antigen (PSA) serum screening has increased the diagnosis of prostate carcinoma. Prostate carcinomas are composed of both indolent and more aggressive carcinomas. The earlier diagnosis of aggressively spreading carcinomas may account for a recent reduction in prostate carcinoma–specific death rates (1).
Difficulty with the earlier concept of diagnosis is that elevated PSA values invariably lead to random prostate biopsies, which, in turn, lead to the discovery of incidental, often un symptomatic tumour .Meanwhile, these same random biopsies may miss significant disease. Thus, MRI has a role along with PSA for localisation of biopsy sites and pin pointing those tumours more likely to cause death if left untreated.
In present context, suspicion of prostate adenocarcinoma is primarily based on 3 diagnostic modalities: manual rectal examination by surgeon, Assessment of levels of Prostate specific antigen (PSA) and trans rectal ultrasound (TRUS) . This usually followed by sono -guided biopsies. The latter is recognized by urologists as the first choice in the diagnosis of prostate pathologies. However, all three modern imaging modalities, namely, computer tomography, ultrasonography, and magnetic resonance (MR), have been debated to have limitations in the diagnosing prostate carcinoma (2).
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