Value of dynamic contrast-enhanced MRI and DWI in diagnosis of prostate cancer and its pathological comparison

This study aims to assess the diagnostic utility of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) in the detection of prostate cancer (PCa) and to investigate the correlation between DCE-MRI signal intensity-time (SI-T) curve parameters and angiogenesis in cancerous lesions. A total of 56 PCa patients and 50 benign prostatic hyperplasia (BPH) patients were enrolled, and their DCE-MRI and DWI images before surgery were analyzed. We also examined the association between DCE-MRI SI-T curve parameters and vascular endothelial growth factor (VEGF) or microvessel density (MVD). In the early stage of DCEMRI, both PCa and BPH lesions exhibited higher enhancement levels compared to the surrounding normal prostate tissue, and during delayed scanning, BPH lesions and adjacent normal prostate tissue demonstrated substantial enhancement with minimal distinction. Conversely, PCa lesions exhibited relatively low signal intensity changes, distinguishing them from the surrounding normal tissue. Most SI-T curve patterns for PCa patients exhibited ascending and descending profiles, whereas BPH patients predominantly exhibited plateau or ascending curves (p < 0.05). PCa patients had lower peak times, higher enhancement degrees and rates, and elevated VEGF positivity rates and MVD counts compared to BPH patients (p < 0.05). Correlation analysis revealed a negative correlation between peak times of SI-T curve parameters and VEGF and MVD expression levels, while enhancement degree and rate exhibited positive correlations with these parameters (p < 0.05). In DWI images, hyperplastic foci were primarily isointense or slightly hyperintense, while cancerous foci were predominantly markedly hyperintense. Higher b-values were associated with lower apparent diffusion coefficient (ADC) values. However, across various b-values, PCa consistently exhibited lower ADC values than BPH (p < 0.05). DCE-MRI and DWI are valuable tools for distinguishing between PCa and BPH.