Is contrast enhancement needed for diagnostic prostate MRI?

Scialpi, Michele; Rondoni, Valeria; Aisa, Maria Cristina; Martorana, Eugenio; D’Andrea, Alfredo; Malaspina, Corrado Maria; Orlandi, Agostino; Galassi, Giorgio; Orlandi, Emanuele; Scialpi, Pietro; Dragone, Maria Lúcia Suzigan; Palladino, D.; Simeone, Annalisa; Amenta, M.; Bianchi, Giampaolo

doi:10.21037/tau.2017.05.31

Cited by 28 publications

(17 citation statements)

References 55 publications

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“…Some authors biopsize all PI-RADS score 3 lesions [44] leading to increased number of unnecessary biopsies, on the other hand, others have demonstrated that PI-RADS score 3 lesions are associated with low likelihood of clinically sPCa, concluding that these lesions should not be sampled but monitored only. [45] Several studies [25,29] have demonstrated the adequacy of MRI lesion volume estimation compared to histopathological tumor volume. According to the Epstein criteria [46] , the presence of sPCa should be predicted by lesion volume measurement, using a cut-off value of 0.5 cm 3 .…”

Section: Biparametric Mri Volume Calculation For the Management Of Scmentioning

confidence: 99%

“…In addition, bpMRI provides similar results to those of mpMRI for the detection and localization of PCa. [24,29] Different studies have also demonstrated the validity of the lesion volume as predictor of PCa and aggressiveness of the lesion. [30] Several authors have also reported a good correlation between radiologic estimation of the lesion volume and histology of the tumor volüme.…”

Section: Introductionmentioning

confidence: 99%

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Biparametric MRI of the prostate

Scialpi

D’Andrea

Martorana

et al. 2017

Turkish Journal of Urology

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Biparametric Magnetic Resonance Imaging (bpMRI) of the prostate combining both morphologic T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI) is emerging as an alternative to multiparametric MRI (mpMRI) to detect, to localize and to guide prostatic targeted biopsy in patients with suspicious prostate cancer (PCa). BpMRI overcomes some limitations of mpMRI such as the costs, the time required to perform the study, the use of gadolinium-based contrast agents and the lack of a guidance for management of score 3 lesions equivocal for significant PCa. In our experience the optimal and similar clinical results of the bpMRI in comparison to mpMRI are essentially related to the DWI that we consider the dominant sequence for detection suspicious PCa both in transition and in peripheral zone. In clinical practice, the adoption of bpMRI standardized scoring system, indicating the likelihood to diagnose a clinically significant PCa and establishing the management of each suspicious category (from 1 to 4), could represent the rationale to simplify and to improve the current interpretation of mpMRI based on Prostate Imaging and Reporting Archiving Data System version 2 (PI-RADS v2). In this review article we report and describe the current knowledge about bpMRI in the detection of suspicious PCa and a simplified PI-RADS based on bpMRI for management of each suspicious PCa categories to facilitate the communication between radiologists and urologists.

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Section: Biparametric Mri Volume Calculation For the Management Of Scmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Biparametric MRI of the prostate

Scialpi

D’Andrea

Martorana

et al. 2017

Turkish Journal of Urology

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“…The advantages of bpMRI are to reduce costs and examination times (approximately 15-20 minutes) and to eliminate the potential risks of nephrogenic systemic fibrosis, kidney failure and accumulation of gadolinium-based contrast agents in the brain. [18,19] This encourage its use in clinical practice for PCa detection both in men with and without prior biopsies. [20] Detection rate of PCa at biopsy for PI-RADS 3 lesions MRI/TRUS guided fusion prostate biopsy has demonstrated a significant increase in cancer detection rate compared to standard biopsy (64% vs 18-35%).…”

mentioning

confidence: 93%

“…[26] bpMRI protocol and image analysis In our 5-year experience we used a 3T MR unit, without endorectal coil, which generally produces images with higher signal-to-noise ratio and better spatial resolution as compared to 1.5 T systems. As alternative to mpMRI [19,27] , bpMRI protocol excludes the DCE-MRI sequences and includes combined axial fat suppression T1W, T2W and DW MRI series. BpMRI minuscola seems reasonable in the clinical situation where prostate MRI is used as a method for risk stratification of clinically significant PCa in patients with elevated PSA.…”

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confidence: 99%

Score 3 prostate lesions: a gray zone for PI-RADS v2

Scialpi

Martorana

Aisa

et al. 2017

Turkish Journal of Urology

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Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) does not offer a precise guidance on the clinical management (biopsy or not biopsy) for PI-RADS v2 score 3 lesions. Lesion volume calculated on biparametric MRI (bpMRI) [T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI)] by introducing a cut-off of 0.5 mL, allows to distinguish the lesions assigned by the multiparametric MRI (mpMRI) to the category PI-RADS v2 score 3 in two subgroups: a) Indolent or low risk lesions with volume <0.5 mL, and b) Significant or high risk lesions with volume ≥0.5 mL. For mpMRI lesions assigned to PI-RADS v2 score 3, we suggest the following management: 1) Subgroup a (low-risk lesion): Clinical surveillance (accurate evaluation of age and clinical informations, periodic monitoring of prostate specific antigen value and repeated bpMRI 1 year later); 2) Subgroup b (high-risk lesion): Targeted biopsy. The proposed management would reduce the use of unnecessary biopsies and increase the diagostic yield of significant prostate cancer of approximately 50% and 30% respectively. These approaches encourage the radiologist to adopt MRI lesion volume to improve PI-RADS v2 and to optimize the management of PI-RADS v2 score 3 lesions.

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“…DK-MRG, radikal prostatektomi, radyoterapi veya fokal tedavi uygulanan hastalarda tedaviye yanıtın değerlendirilmesi ve tedavi sonrası lokal rekürrensin tanısında fayda sağlamaktadır. Ayrıca aşağıda daha ayrıntılı olarak tartışacağımız tümoral mikrovaskülari-zasyon ve anjiyogenezin değerlendirilmesini de sağlamaktadır [4,5].…”

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Prostat Kanseri Tani ve Yonetiminde Dinamik Kontrastli MRG

Uysal¹,

Fakultesi²,

Özmen³

2018

Trd Sem

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GİRİŞProstat kanseri erkeklerde en sık görülen malign tümördür ve kanser ölümlerinin ikinci en sık nedenidir. Manyetik rezonans görüntüleme (MRG) anatomik bilgiler yanında fonksiyonel bilgiler de sağlaya-rak prostat kanserinin erken teşhisi, lokalizasyonu, evrelemesi ve biyolojik agresifliğin belirlenmesinde; tedavi sonrası ise takip ve rekürren kanserin tespitinde önemli bir rol üstlenmektedir [1,2].Prostat Görüntüleme Raporlama ve Veri Sisteminin 2. Sürümü (PIRADS v2) prostat kanserinin tespiti, lokalizasyonu, karakterizasyonu ve risk sınıflandırmasını geliştirmek ve multiparametrik prostat MRG tetkikinin çekimi, yorumlanması ve raporlanmasında uluslararası standardizasyon sağlamak için oluşturulmuş bir kılavuzdur. PIRADS V2'de önemli değişik-liklerden biri lezyon lokalizasyonuna göre dominant sekansın değişmesi olup; transizyonel zon lezyonlarında T2 ağırlıklı görüntüler, periferal zonda (PZ) ise difüzyon ağırlıklı görüntü-leme (DAG) dominant sekansdır [1,2]. Dinamik Kontrastlı Görüntüleme Faydaları, Kontrast Madde Gerekli mi?Özellikle PZ'deki DAG'ye dayalı PI-RADS 3 skoru, klinik olarak karar vermek (biyopsi veya takip) için yetersizdir. Dinamik kontrastlı MRG (DK-MRG), eğer DK-MRG bulguları pozitif çıkarsa, esas olarak PI-RADS 3 lezyonların skorunu PI-RADS 4'e yükseltmektedir [2].Dinamik kontrastlı görüntüleme, PZ'deki PI-RADS 3 ve 4 lezyonlarda kanser saptama olasılığını artırmaktadır. Greer ve arkadaşları-nın çalışmaları periferal zonda DK-MRG bulgularının pozitif olması durumunda PI-RADS 3 skorunu PI-RADS 4'e yükselten PI-RADS 3+1 stratejisini desteklemektedir [2]. Ayrıca aynı çalışmadan elde edilen veriler DK-MRG pozitifliğinin tüm PIRADS skorları için periferal zonda kanser saptama olasılığını arttırdığını göstermekte olup bu etki kısmen transizyonel zonda da görülmekle birlikte PZ lezyonların-daki kadar yarar sağlamamaktadır. Dolayısı

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Is contrast enhancement needed for diagnostic prostate MRI?

Cited by 28 publications

References 55 publications

Biparametric MRI of the prostate

Biparametric MRI of the prostate

Score 3 prostate lesions: a gray zone for PI-RADS v2

Prostat Kanseri Tani ve Yonetiminde Dinamik Kontrastli MRG

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