Prostate cancer is one of the most common malignancy in the male population. Multiparametric magnetic resonance imaging (MRI) of the prostate is the main imaging modality to localize, determine the stage, and predict the aggressiveness of the prostate cancer. However, it is costly and with risks of complications from instillation of Gadolinium contrast. Bi-parametric prostate MRI (bpMRI), on the other hand, removes the dyanmic contrast-enhanced (DCE) imaging, and showed to be sufficient to detect clinically significant prostate cancer. The aim of this study is to compare the diagnostic accuracy of bpMRI and mpMRI in prostate cancer detection in a private tertiary institution in Quezon City.

A retrospective cross-sectional study was done to gather patients who underwent bi-parametric MRI of the prostate as well as multiparametric MRI of the prostate, and subsequent standard prostate biopsy. Patients who had PI-RADS 3, 4, and 5 lesions were included and was categorized depending on the histopathology results whether it was benign, prostate cancer with either gleason 6, gleason 7, gleason 8 or above. Clinically significant prostate cancer was identified for those who had gleason 7 and above patients.

In detecting prostate cancer, bpMRI has 97% sensitivity, 88% specificity, 85% PPV and 98% NPV, while mpMRI has 97% sensitivity, 87% specificity, 97% PPV and 91% NPV. In detecting clinically significant prostate cancer, bpMRI has 97% sensitivity, 79% specificity, 70% PPV and 98% NPV, while mpMRI has 97% sensitivity, 78% specificity, 67% PPV and 98% NPV.

No significant difference was found between bpMRI and mpMRI in diagnosing clinically significant prostate cancer in patients. bpMRI reduces cost, faster, cheaper, safer alternative by reducing cost exposure compared to mpMRI. BpMRI is a cost-effective and safe diagnostic tool in identifying clinically significant prostate cancer and avoid unnecessary prostate biopsies in Filipino patients.