ESUR prostate MR guidelines 2012

Abstract

The aim was to develop clinical guidelines for multi-parametric MRI of the prostate by a group of prostate MRI experts from the European Society of Urogenital Radiology (ESUR), based on literature evidence and consensus expert opinion. True evidence-based guidelines could not be formulated, but a compromise, reflected by “minimal” and “optimal” requirements has been made. The scope of these ESUR guidelines is to promulgate high quality MRI in acquisition and evaluation with the correct indications for prostate cancer across the whole of Europe and eventually outside Europe. The guidelines for the optimal technique and three protocols for “detection”, “staging” and “node and bone” are presented. The use of endorectal coil vs. pelvic phased array coil and 1.5 vs. 3 T is discussed. Clinical indications and a PI-RADS classification for structured reporting are presented.Key Points• This report provides guidelines for magnetic resonance imaging (MRI) in prostate cancer.• Clinical indications, and minimal and optimal imaging acquisition protocols are provided.• A structured reporting system (PI-RADS) is described.

The Roles of Multiparametric Magnetic Resonance Imaging, PCA3 and Prostate Health Index—Which is the Best Predictor of Prostate Cancer after a Negative Biopsy?

“…The results may actually underestimate the true capabilities of mp-MRI at a center of excellence using 3T machines and modern software, even if the imaging protocol used satisfied the recommendations from a European consensus meeting. 17 This effect would be less if a standardized reporting scheme is used like the PI-RADS classification, 14,30 but this prospective study started in 2011 when the classification was not yet published. Finally, the study does not include any discussion of costs and logistics.…”

“…The signs considered suspicious for PCa are reported in the supplementary Appendix. 10,14,18 Overall the mp-MRI finding was considered positive if at least 2 of the 3 MR sequences (T2-weighted, DWI and dynamic contrast enhanced MRI) produced suspicious findings.…”

MRT der Prostata: Empfehlungen zur Vorbereitung und Durchführung

“…A high temporal resolution (at least 9 seconds) is a requirement for being able to measure the rapid enhancement of contrast agent in the prostate [31]. DCE-MRI is essential particularly for diagnosing recurrence after prostatectomy or radiotherapy [32].…”

Multiparametric Magnetic Resonance Imaging in the Detection of Prostate Cancer

“…Fast T1w gradient echo sequences with a temporal resolution of 4 -10 seconds are primarily used in prostate imaging. Measurements should be performed over a period of up to approximately 5 minutes after contrast agent application [13]. The enhancement can be displayed in the form of curves over time thus helping to characterize tissues.…”

“…In 2012 the European Society of Urogenital Radiology (ESUR) created the Magnetic Resonance Prostate Imaging Reporting and Data System (MR PI-RADS) as part of its MRI guidelines for prostate imaging [13]. Based on the breast imaging reporting and data system (BI-RADS), a standardized method for reporting multiparametric MRI of the prostate for the detection of prostate cancer is proposed here.…”