Multiparametric Magnetic Resonance Imaging in the Detection of Prostate Cancer

Abstract

!Prostate cancer is the most common malignancy in men, but only about 10 % of patients die from that cancer. Recent studies suggest that not all patients benefit from a radical therapeutic approach. When prostate cancer is suspected, magnetic resonance imaging (MRI) can make an important contribution to cancer localization within the prostate. Many studies show that T2-weighted morphologic imaging should be supplemented by multiparametric MRI techniques including diffusion-weighted imaging, contrast-enhanced sequences, and MR spectroscopy. This approach detects aggressive prostate cancer with high sensitivity and specificity. The findings of multiparametric MRI additionally contribute information to the assessment of cancer aggressiveness. The use of these multiparametric MRI techniques will gain an increasing role in the clinical management of prostate cancer patients. They can help in establishing a definitive diagnosis with a minimum of invasiveness and may also contribute to optimal individualized treatment. This review article presents the different techniques of multiparametric MRI and discusses their contribution to the detection of prostate cancer. Moreover, this review outlines an objective approach to image interpretation and structured reporting of MRI findings using the PI-RADS criteria. The review concludes with an outline of approaches to prostate biopsy on the basis of MRI (transrectal ultrasound, direct MRI guidance of tissue sampling, and MRI-ultrasound fusion biopsy) and emerging future uses of MRI in the planning of focal treatment options and in the active surveillance of patients diagnosed with prostate cancer.Citation Format:

Comparison of preoperative locoregional Ga‐68 PSMA‐11 PET‐CT and mp‐MRI results with postoperative histopathology of prostate cancer

“…Some factors related with the disease such as regional lymph node (LN) metastases, gross tumor volume, and/or locoregional invasion of the tumor may cause alteration of the surgical technique or to terminate the operation . Hence, to better guide PCa patients' management (observation, salvage local therapy, and systemic therapy) and to detect locoregional and distant metastatic lesions accurately, several studies regarding imaging modalities have been carried out …”

“…To assess locoregional tumor status of primary PCa, MRI is a well‐established, highly accurate imaging modality . With its high soft‐tissue contrast and high resolution, MRI is one of the best imaging modality for the prostate compared to other conventional imaging methods .…”

“…To assess locoregional tumor status of primary PCa, MRI is a well‐established, highly accurate imaging modality . With its high soft‐tissue contrast and high resolution, MRI is one of the best imaging modality for the prostate compared to other conventional imaging methods . Though to improve diagnostic accuracy of MRI with high sensitivity and specificity for PCa, combination of morphological sequences and functional imaging techniques have been used together over the past few years which was referred as multiparametric MRI (mp‐MRI) .…”

Evaluation of the ‘Prostate Interdisciplinary Communication and Mapping Algorithm for Biopsy and Pathology’ (PIC-MABP)

“…Multiparametric MRI (mpMRI) of the prostate and targeted biopsies proved to be reliable diagnostic tools for detecting prostate cancer [1][2][3][4][5] and show growing acceptance primarily for examining patients with negative systematic biopsies but ongoing cancer suspicion.…”

Die Echtzeit-MRT/US-Fusionsbiopsie in Patienten mit und ohne Vorbiopsie mit Verdacht auf ein Prostatakarzinom

“…Aktualisierung September 2014) für eine optionale Anwendung der endorektalen MRT nach negativer Biopsie aus, um die Anzahl unnötiger Biopsien zu reduzieren. Gerade die Anwendung der MRT und die Kombination der T2-gewichteten morphologischen MRT mit meist diffusionsgewichteten und kontrastmittelgestützten Sequenzen im Sinne einer multiparametrischen (mp)MRT ermöglicht eine bessere Aggressivitätsbeurteilung des PCa [5]. Die Einstufung der suspekten Herde erfolgt im Rahmen der MR-Befundung auf einer Punkteskale von 1-5 für jede Sequenz gemäß den Kriterien des "Prostate Imaging Reporting and Data Systems" (PI-RADS); es resultiert in einem gesamt MR-PI-RADS-Wert zwischen ebenfalls von 1-5, wobei ein Wert von 5 eine hohe Wahrscheinlichkeit für das Vorliegen eines malignen Geschehens impliziert [6].…”