Keywords
Magnetic Resonance Imaging (MRI)
Trans-Rectal Ultrasound (TRUS)
PI-RADS
Histopathology
PSA, Sensitivity
Specificity
Diagnostic accuracy
Ethnic variation
How to Cite
Abstract
Background: Prostate cancer is one of the leading malignancies affecting men globally. Early and accurate diagnosis is essential to reduce morbidity and mortality. Magnetic Resonance Imaging (MRI) and Trans-Rectal Ultrasound (TRUS) are widely used imaging techniques for prostate cancer detection, but their diagnostic accuracy varies. This study aimed to compare the effectiveness of MRI and TRUS in identifying clinically significant prostate cancer (csPCa), using histopathology as the gold standard, and to examine associations with PSA levels and ethnicity.
Objective: To Compare the Magnetic Resonance Imaging and Trans-Rectal Ultrasound in Identifying Clinically Significant Prostate Cancer Among Diverse Ethnic Groups Using Histopathology as the Gold Standard.
Methods: A total of 120 male patients underwent PSA testing, MRI (reported using PI-RADS scores), TRUS, and histopathological evaluation via biopsy. Diagnostic performance was assessed using sensitivity and specificity calculations. Statistical associations between imaging findings, PSA levels, ethnicity, and histopathological results were evaluated using Chi-square and likelihood ratio tests.
Results: MRI demonstrated a high sensitivity of 95.5% but low specificity of 6.45%. TRUS showed a sensitivity of 68.5% and specificity of 25.8%. A statistically significant association was found between PI-RADS scores and histopathological outcomes (p = 0.017), confirming its diagnostic utility. No significant associations were found between MRI findings (p = 0.801), TRUS findings (p = 0.110), PSA levels (p = 0.348), or ethnicity (p = 0.529) and histopathological results.
Conclusion: MRI is more sensitive than TRUS in detecting csPCa, but its low specificity limits its standalone use. The significant correlation between PI-RADS and histopathology (p = 0.017) supports its use in clinical decision-making. A multimodal diagnostic approach combining MRI, TRUS, PSA, and biopsy is recommended for accurate and reliable prostate cancer diagnosis.