الفهرس 
Anatomy of the ProstateOnly 14 pages are availabe for public view
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Abstract
Prostate cancer is the most common malignant tumor in men all over the world and is also the second important cause of cancer-related deaths in men after lung cancer. The exploration of noninvasive imaging methods that have the potential to improve specificity, while maintaining high sensitivity is still critically needed. Of all functional MR imaging techniques, diffusion-weighted imaging (DWI) is the most practical and simple in its use. It has the advantages of not requiring IV contrast material and of being simple to process. Moreover, DWI requires less time to acquire than proton MR spectroscopy and less technologist training to perform. However, it has the disadvantages of being susceptible to motion and magnetic field in homogeneities. The cancer tissue generally tends to have more restricted diffusion than non-cancerous tissue. The ADC values of cancerous lesions have been found lower than normal parenchyma of the prostate. Subsequently, DWI and ADC have become powerful indicators for the characterization of prostatic tissue and differentiate between normal prostatic tissue, benign prostatic hyperplasia, and prostatic cancer. Patients and methods: During a period of 24 months duration from January 2020 to January 2022, sixty specimens were enrolled in the study. All patients who came to the Radiology Department presented with prostatic problems. All the patients agreed to participate in the study and were assigned the consent after getting approval from the ethical committee of our institute. Results: All the prostatic cancer lesions in DWI appeared bright (significant diffusion restriction either high, moderate, or mild), while 95% of BPH lesions had no diffusion restriction, only 5% of BPH lesions showed mildly elevated signal in the diffused weighted images. The normal prostatic tissue central or peripheral zones had no restricted diffusion. The mean ADC value of prostate carcinoma was significantly lower than that of normal CG, PZ, and BPH nodules (p-value < 0.001). The PZ tissue had a significantly higher ADC value than normal CZ (p< 0.001). The ADC value of the BPH lesion was significantly lower than that of CZ (p < 0.001). For prostate cancers, the sensitivity and Specificity of the ADC value to differentiate between the cancer prostatic tissue and the normal peripheral zone tissue or BPH was significantly high at 100% (with a cutoff point≤ 1.051). While the sensitivity and Specificity of the ADC value to differentiate between the benign prostatic hyperplasia nodules and the normal central zone tissue was 100% and 70% respectively with a positive predictive value of 76.9% (with cutoff point ≤ 1.587).
Conclusion: Our study results show that DWI can be used to acquire data on tissue characteristics of the different anatomical zones of the prostate gland. Prostatic carcinoma can cause restricted diffusion of water relative to that of normal tissue and BPH resulting in increased signal intensity on DWI and decreased ADC values, which can be used in the differential diagnosis of benign and malignant lesions, and it will be a promising strategy in clinical practice.