الفهرس 
Introduction and aim of the workOnly 14 pages are availabe for public view
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Abstract
Objective: Evaluation of non invasive MRI techniques for prostate cancer (PCa) diagnosis in intermediate/high risk patients (detection and localization). Material And methods: Between July 2008-July 2009, a prospective study was conducted. Patients ≥40 years, positive digital rectal examination (DRE), PSA > 4ng/ml and signed informed consent were the inclusion criteria. Non-invasive MRI; T2W (T2-weighted), DWI (Diffusion Weighted Image) and DCE (Dynamic Contrast-Enhanced) were performed at 1.5T with a body coil combined with a spine coil in consecutive 100 cases. The histopathology of biopsy was used as reference standard. MRI has been evaluated by two examiners; both of them were blinded regarding pathological findings. Tumor detection and localization accuracy were statistically analyzed. Results: Group A-cancerous; 75cases (56 % had Gleason score > 6) & Group B-non-cancerous; 25 cases. Mean PSA was 30.7 and 9.2 ng/ml in group A and B respectively. Sensitivity of T2W, DWI and DCE were 89.6, 83.8 and 77.4% respectively, while Specificity were 36.4, 60.9 and 60% respectively. Combination of at least two techniques shows an increase of sensitivity and specificity to 86.7% and 70.8% respectively. Accuracy of focal lesion detection of T2W, DWI, DCE & combined was 23.1, 42.3, 38.1 and 57.1 % respectively. Conclusion: In patients with suspicious intermediate/high risk PCa (High PSA, more than clinical T2b by DRE), using of at least two of non-invasive MRI techniques (T2W, DWI and/or DCE) can achieved 86% for tumor detection and 57-75 % of localization accuracy. Therefore it guides targeted biopsy and avoiding unnecessary biopsies.