Clinical significance of MRI-DWI and PWI scans in identifying benign prostatic hyperplasia and prostate cancer

To investigate the importance of magnetic resonance diffusion-weighted imaging (DWI) and perfusion-weighted imaging (PWI) for distinguishing between prostate cancer (PCa) and prostate hyperplasia (BPH). A total of 78 patients with prostate disorders and 20 individuals without prostate disorders (control group) treated between June 2020 and June 2023 were examined. Among them, 30 were pathologically diagnosed with BPH and 48 with PCa. (Magnetic Resonance Imaging-diffusion weighted imaging) MRI-DWI and PWI parameters, specifically the apparent diffusion coefficient (ADC), maximum slope of perfusion curve (SSmax) and quasi-T2 relaxation rate (ΔR2*peak), were compared among the three groups. Microvessel density (MVD) of vascular endothelial growth factor (VEGF) and PCa were quantified through immunohistochemistry. No statistically significant differences were observed in ADC values within the transition zone of the prostate among the control group, BPH and PCa patients (p > 0.05), while significant differences in ADC values were observed within the peripheral zone of the three groups (p < 0.05). The ADC and T2 values of BPH lesions were significantly higher than those of PCa tissue (p < 0.05). Moreover, SSmax and ΔR2*peak values were significantly different in BPH lesions (p < 0.05). MVD levels were significantly lower in BPH lesions compared to PCa lesions, and the positive expression rate of VEGF was also significantly lower in BPH lesions (p < 0.05). Correlation analysis revealed a positive association between SSmax and ΔR2*peak levels in PCa lesions and their MVD and VEGF levels (p < 0.05). Both MRI-PWI and DWI imaging demonstrate substantial value in distinguishing between PCa and BPH. Furthermore, a significant correlation was observed between PWI scan parameters, such as SSmax, ΔR2*peak and VEGF and MVD levels in tumor tissues, offering a promising non-invasive option for assessing tumor neovascularization.