The authors evaluated a magnetic resonance (MR) imaging-compatible biopsy device comprising a needle guide that can be visualized with MR imaging and manipulated mechanically from outside the MR unit. With approval from the local ethics committee and patient consent, this device was tested in 12 patients by using a closed 1.5-T MR unit and a body phased-array coil. Patients had elevated prostate-specific antigen levels (6-60 ng/mL) and one or more areas in the prostate that were suspicious for carcinoma at prebiopsy MR imaging. Biopsy was performed with transrectal access and with the patient prone. A 16-gauge MR imaging-compatible needle was successfully positioned with the device, and between six and nine tissue cores were obtained in each patient. In one patient, two suspicious basal areas could not be reached with the device. Histologic analysis showed prostate cancer in five patients and prostatitis in six. No complications were observed. The device enabled MR imaging-guided core-needle biopsy of prostate areas suspicious for cancer on MR images.

Experimental data show accumulation of superparamagnetic iron oxide (SPIO) particles in atherosclerotic plaques. SPIO uptake occurred in plaques, suggesting an increased endothelial permeability and macrophage infiltrates as signs of inflammatory plaque activity. We incidentally observed SPIO uptake in aortic and arterial wall segments in patients who had originally received the magnetic resonance (MR) contrast agent for staging lymph node metastases. Twenty patients (19 male, 1 female; mean age, 64; range, 41-78 years) with bladder or prostate cancer underwent MR imaging (MRI) using a T2*-weighted high-resolution gradient-echo sequence prior to and 24 -36 hours after intravenous injection of 2.6 mg of Fe/kg of SPIO (Sinerem ). The aorta, both common external and internal iliac, as well as both superficial femoral arteries, were retrospectively analyzed for atherosclerotic wall changes. One patient was excluded. A positive finding was defined as an area of pronounced signal loss on postcontrast images clearly confined to the arterial wall, which was absent in the precontrast examination or increased in size. Such a finding was observed in one to three arteries in 7 of the 19 patients. The pronounced signal loss in the wall of the aorta and pelvic arteries seen in part of an elderly patient population after intravenous SPIO administration strongly suggests that this contrast agent accumulates in human atherosclerotic plaques. J. Magn. Reson. Imaging 2001;14: 355-361.

In this patient population, MR imaging has higher sensitivity for detection of prostate cancer than DRE or transrectal US.

Intraindividual comparison shows that image quality and delineation of prostate cancer at 1.5 T with the use of an endorectal coil in a pelvic phased-array is superior to the higher field strength of 3.0 T with a torso phased-array coil alone. As long as no endorectal coil is available for 3-T imaging, imaging at 1.5 T using the combined endorectal-body phased-array coil will continue to be the gold standard for prostate imaging.