Özet:

Objective: To evaluate the contribution of magnetic resonance imaging for prostate cancer diagnosis and decide the most beneficial, accurate and appropriate MRI method. Materials and Methods: The study was planned as prospective and single-centered. Patients , with 3-10 ng/ml serum PSA level and normal digital rectal examination results , scheduled for initial prostate biopsy were included in the study between February 2013 and March 2014. Each patient were screened by diffusion MRI, MRI spectroscopy, dynamic-contrast MRI and T2 sequenced MRI one week prior to biopsy. The lesion seen in at least two MRI was accepted as meaningful , therefore, multiparametric MRI was evaluated. Transrectal ultrasound guided biopsies were targeted to lesions seen in MRI. Additional biopsies were directed to the lesions observed by TRUS and MRI. As a result, MRI was regarded as the best methot because of tumor detection rates, sensitivity and density in multivariate analysis. Results: Patients mean age was 61.22 ± 1.0,.the mean PSA value 5.13 ± 0.19 ng / ml, mean prostate size 48.96 ± 2.67 grams. The mean of core biopsy was12.73 ± 0.13 . Of 53 patients , in 19 prostate cancer was detected Tumor core detection mean was 3.21 ± 0.45 . ASAP in 2 patients, gleason 3 + 3 tumor in 13patients, gleason 3 + 4 tumor in 4 patients was observed. Overall tumor detection rate was 35.8%. . Evaluating all MRI methods we concluded that highest sensitivity was in spectroscopic MR. Maximum spesificity was in dynamic contrast-enhanced MRI. Highest positive predictive value was in dynamic contrast-enhanced MRI. Highest negative predictive value was in spectroscopic MRI. In multivariate analysis (logistic regression analysis) determining imaging methods affecting the biopsy results,we ended up that all methods, except TRUS, affect biopsy results. The most affecting methods were multiparametric MRI and contrast-enhanced dynamic MRI and MRI spectroscopy, T2 sequential MRI, respectively. Diffusion MRI was on the borderline because of 0.05 p-value . Conclusion: More tumors were detected and observed in the lesions in the MRI pre_biopsy. The most benefical accurate and detectful methot is multiparametric MRI to locate and detect these lesions.

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