Prostate Cancer Detection in Patients With Total Serum Prostate-Specific Antigen Levels of 4–10 ng/mL: Diagnostic Efficacy of Diffusion-Weighted Imaging, Dynamic Contrast-Enhanced MRI, and T2-Weighted Imaging

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Abstract
OBJECTIVE. The purpose of this study is to evaluate the utility of T2-weighted imaging, dynamic contrast-enhanced MRI (DCE-MRI), and diffusion-weighted imaging (DWI) for detecting prostate cancer in patients with total serum prostate-specific antigen (PSA) levels of 4–10 ng/mL, which is referred to as the “gray zone.” MATERIALS AND METHODS. Fifty patients with gray-zone PSA levels underwent MRI before biopsy. According to the sites of biopsy, the prostate was divided into eight regions on MRI scans. These regions were evaluated individually for the following features: detectability of prostate cancer on per-region and per-patient bases, and relationship between tumor size and positive or negative MRI findings for tumor detection. RESULTS. On a per-region basis, the sensitivity and specificity of tumor detection were 36% and 97% for T2-weighted imaging, 43% and 95% for DCE-MRI, 38% and 96% for DWI, and 53% and 93% for the combined method of MRI, respectively. The sensitivity of combined MRI to detect tumor...

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