A multiparametric MRI score for prostate cancer detection: Performance in patients with and without endorectal coil

Purpose: To assess the diagnostic performance of multiparametric MRI (mpMRI), in the detection of prostate cancer in two different coil setting: endorectal coil (ERC) versus phased array coil alone (PAC). Materials and Methods: The study included 302 out of 395 consecutive patients with PSA values between 2.5-4 ng/ml and an abnormal Digital Rectal Examination (DRE), or patients with PSA values between 4-10ng/ml, independently from DRE. Each patient provided informed consent to undergo at serum free/total PSA ratio (f/t PSA) assay, morphological MRI (mMRI), DWI, MRS, and Trans Rectal Ultrasonography (TRUS) biopsy. The MRI data sets were scored singularly and then mMRI, DWI and MRS data were combined in a single score (cMRI score). cMRI score was correlated to negative biopsies and Gleason score biopsies. ROC curve and McNemar tests were performed. Results: cMRI score showed high value of sensitivity and NPV for both coil setting (84% and 93% respectively using ERC, 87% and 87% respectively using PAC). cMRI score using ERC did not show statistical superiority compared with cMRI score using PAC alone (p value at McNemar test > 0.05). A significant correlation was obtained comparing the cMRI score to the Gleason score for both coil conditions. Conclusions: Pelvic phased array coil imaging of the prostate produces high quality images and the overall performance in prostate cancer detection is equal than those obtained with endorectal coil imaging.