A narrative review of biparametric MRI (bpMRI) implementation on screening, detection, and the overall accuracy for prostate cancer

Abstract

Prostate cancer is the most common malignancy in American men following skin cancer, with approximately one in eight men being diagnosed during their lifetime. Over the past several decades, the treatment of prostate cancer has evolved rapidly, so too has screening. Since the mid-2010s, magnetic resonance imaging (MRI)–guided biopsies or ‘targeted biopsies’ has been a rapidly growing topic of clinical research within the field of urologic oncology. The aim of this publication is to provide a review of biparametric MRI (bpMRI) utilization for the diagnosis of prostate cancer and a comparison to multiparametric MRI (mpMRI). Through single-centered studies and meta-analysis across all identified pertinent published literature, bpMRI is an effective tool for the screening and diagnosis of prostate cancer. When compared with the diagnostic accuracy of mpMRI, bpMRI identifies prostate cancer at comparable rates. In addition, when omitting dynamic contrast-enhanced (DCE) protocol to the MRI, patients incur reduced costs and shorter imaging time while providers can offer more tests to their patient population.

Biparametric MRI-based radiomics classifiers for the detection of prostate cancer in patients with PSA serum levels of 4∼10 ng/mL

“…The PI-RADS v2.1 emphasizes that although DCE imaging is essential, its role in the determination of the PI-RADS category is secondary to that of T2-WI and DWI (20). Previous studies have shown that in those patients with PSA levels of 4-10 ng/mL, biparametric MRI (bpMRI) achieved better performance than conventional MRI and mpMRI with higher specificity in detecting PCa and reduced unnecessary biopsies (21)(22)(23). Accordingly, this study aimed to investigate the effectiveness of radiomic features extracted from bpMRI in the identification of PCa and to develop and validate a radiomic nomogram for PCa diagnosis in a subgroup of patients with PI-RADS ≤3 lesions and PSA serum levels of 4-10 ng/mL, providing a practical tool for accurate diagnosis and personalized treatment.…”

Could Biparametric MRI Replace Multiparametric MRI in the Management of Prostate Cancer?

“…The most serious of these are nausea, vomiting, dizziness, headache, seizure, pulmonary edema, and anaphylaxis [ 64 ], reactions that, while rare, can put the patients in real danger, given that the majority of patients have associated pathological conditions due to PCa and its treatment, other comorbidities, and age. The presence of end-stage renal disease, as well as acute kidney injury, chronic kidney disease, and dialysis, is another issue related to contrast agents [ 65 , 66 ]. The majority of the concerns raised in studies regarding gadolinium-based contrast agents (GBCA) are related to nephrogenic systemic fibrosis [ 66 ].…”

“…As bpMRI does not require the acquisition of contrast agents, it is less expensive than mpMRI. In countries such as the United States of America, the costs vary depending on the healthcare services provided, whereas in Korea, for example, bpMRI costs half as much as mpMRI [ 65 ].These recommendations and suggestions emphasize that the importance of using bpMRI instead of mpMRI whenever possible.…”

FastMRI Prostate: A public, biparametric MRI dataset to advance machine learning for prostate cancer imaging

“…Therefore, early detection strategies and improved management approaches are crucial for reducing mortality rates associated with PCa. MRI with T2-weighted and diffusion-weighted sequences is an effective diagnostic tool used in PCa management 8 – 11 . Accelerating imaging through advanced reconstruction techniques applied to under-sampled data holds the potential to enhance cost-effectiveness in prostate MRI workflows, while automated triage systems can contribute to increased efficiency and broader accessibility of prostate MRI.…”