Multiparametric MRI of Prostate Cancer: Recent Advances

Ventrella, Elena; Eusebi, Laura; Carpagnano, Francesca Anna; Bartelli, Francesco; Cormio, Luigi; Guglielmi, Giuseppe

doi:10.1007/s40134-020-00363-1

Cited by 6 publications

(7 citation statements)

References 37 publications

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“…The use of an endorectal coil (ERC) is a topic still widely debated today, as it has not yet been established an absolute utility. Indeed, while the ERC, in addition to the surface one, improves spatial resolution and signal-to-noise ratio (SNR), due to its closeness to the prostate gland [5], it is responsible for artifacts and false images. For example, the presence of intestinal peristaltic movements creates concentric artifacts along the margins of the coil itself [23].…”

Section: Technical Artifactsmentioning

confidence: 99%

“…Since a large number of modern equipment, primarily 3 T but at the same time many 1.5 T, are able to provide high quality and fairly satisfactory images from a diagnostic point of view, considering the above and, in addition, the discomfort created by the ERC, the PI-RADS committee does not recommend its use [5].…”

Section: Technical Artifactsmentioning

confidence: 99%

“…In 2012, in fact, the European Society of Urogenital Radiology developed guidelines, under the name of ''Prostate Imaging-Reporting and Data System (PI-RADS)'', about the protocols of acquisition and interpretation of MR imaging of prostate cancer [3, 4 • ]. After a series of revisions to which these guidelines have been submitted, up to the latest version published in 2019 (PI-RADS v2.1), it has been reached to identify milestone sequences of mp-MRI that offer a complete picture of prostatic disease, either anatomically or functionally [5]. In particular, the study of the prostate gland involves the acquisition of anatomical sequences T2-weighted imaging (T2WI), in combination with functional sequences of diffusion-weighted imaging (DWI) and dynamic type after intravenous administration of contrast medium (DCE) [4 • ].…”

Section: Introductionmentioning

confidence: 99%

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Prostate Multiparametric MRI: Common Pitfalls in Primary Diagnosis and How to Avoid Them

Eusebi¹,

Carpagnano

Sortino³

et al. 2021

Curr Radiol Rep

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Purpose of Review To provide the radiologist with basic knowledge about normal and abnormal findings in the prostatic mp-MRI, taking a look at the possible diagnostic pitfalls commonly seen in daily clinical practice, allowing him to recognize and consequently avoid them. Recent Findings Prostate mp-MRI has now become commonly used in most diagnostic imaging centers, as a precise, accurate and above all non-invasive tool, useful in the diagnosis, staging and follow-up of prostate diseases, first of all prostatic carcinoma. For this reason, it is important to take into account the existence of numerous possible anatomic and pathologic processes which can mimick or masquerade as prostate cancer. Summary Through the combination of anatomical (T2WI) and functional sequences (DWI/ADC and DCE), the mp-MRI of the prostate provides all the information necessary for a correct classification of patients with prostate disease, cancer in particular. It is not uncommon, however, for the radiologist to make errors in the interpretation of imaging due to conditions, pathological or otherwise, that mimic prostate cancer and that, consequently, affect the diagnostic/therapeutic process of patients. The strategy, and what this pictorial review aims at, is to learn to recognize the potential pitfalls of the prostatic mp-MRI and avoid them.

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Section: Technical Artifactsmentioning

confidence: 99%

Section: Technical Artifactsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Prostate Multiparametric MRI: Common Pitfalls in Primary Diagnosis and How to Avoid Them

Eusebi¹,

Carpagnano

Sortino³

et al. 2021

Curr Radiol Rep

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“…The study of the prostate with US consists of an evaluation of the gland from a volumetric point of view, with axial and sagittal plane scans with B-mode US, corroborated by Doppler imaging and elastography to identify further possible suspicious lesions, in the face of which CEUS removes all possible doubts. In the end, it is possible to obtain an ''MRI-TRUS fusion map,'' which highlights all prostatic lesions suspected for PCa candidate for biopsy, according to a precise risk stratification [6].…”

Section: Multiparametric Ultrasoundmentioning

confidence: 99%

“…In this regard, although screening is an indispensable tool for early diagnosis and treatment, these investigation techniques are not very specific and not very sensitive, and therefore, there is a risk of incurring clinically significant undiagnosed cancers or clinically insignificant but overestimated cancer [4,5]. Therefore, it is important to identify the most appropriate imaging method in order to improve the detection of prostate cancer and, in recent years, multiparametric Magnetic Resonance Imaging (mp-MRI) seems to have a central role for this purpose [6]. However, mp-MRI also has many limitations, starting from the most common contraindications in the execution of MRI, up to those more specifically related to prostatic mp-MRI, such as endorectal coil discomfort, long duration of the examination, or difficulty in imaging interpretation [7 •• ].…”

Section: Introductionmentioning

confidence: 99%

Prostate Cancer Ultrasound: Is Still a Valid Tool?

Carpagnano

Eusebi²,

Carriero

et al. 2021

Curr Radiol Rep

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Purpose of Review The main purpose of this paper review is to highlight the latest ultrasound (US) imaging technologies of the prostate gland, an organ increasingly at the center of attention in the field of oncological diseases of the male sex, which needs a 360° evaluation in order to obtain tailored therapeutic planning. Specialist urological evaluation is designated for this purpose, together with integrated prostate imaging which currently tends to focus more and more on the use of US imaging and its state-of-the-art technologies in iconographic diagnosis, biopsy and, sometimes, treatment of prostatic cancer. Recent Findings In particular, the main tools to which reference is made, represent a valid aid to basic US technologies already widely known and diffused, like the grayscale US or the Doppler US, for a "multiparametric" evaluation of the prostate cancer. The concept of multiparametricity is explained by the integration of prostate imaging obtained both with the US evaluation of the gland before and after administration of contrast medium, with the elaboration of parametric maps of quantitative measurement of the enhancement, and with elastography that provides information about the tissue consistency, a finding that strongly relates with the degree of cellularity and with the tumor grading. Summary Prostate cancer screening consists of dosing serum levels of prostate-specific antigen (PSA) and performing digit-rectal examination (DRE), more or less associated with transrectal prostate ultrasound (TRUS). However, although these are the most common techniques in clinical practice, they have numerous limitations and make the diagnosis of prostate cancer often challenging. The purpose of mp-US is to enrich the clinical-laboratory data and, above all, the standard US imaging with further details to strengthen the suspicion of malignancy of a prostate tumor, which needs to be addressed to diagnostic deepening with biopsy. This review article provides a summary of the current evidence on mp-US imaging in the evaluation of a clinically significant prostate cancer, comparing the data obtained to the imaging of mp-MRI, the reference tool both in diagnosis and staging.

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