PI-RADS Committee Position on MRI Without Contrast Medium in Biopsy-Naive Men With Suspected Prostate Cancer: Narrative Review

Schoots, Ivo G.; Barentsz, Jelle O.; Bittencourt, Leonardo Kayat; Haider, Masoom A.; Macura, Katarzyna J.; Margolis, Daniel; Moore, Caroline M.; Oto, Aytekin; Panebianco, Valeria; Siddiqui, Mohummad Minhaj; Tempany, Clare M.; Türkbey, Barış; Villeirs, Geert; Weinreb, Jeffrey C.; Padhani, Anwar R.

doi:10.2214/ajr.20.24268

Cited by 102 publications

(59 citation statements)

References 48 publications

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“…Promising strategies include MRI without contrast medium and imaging in the axial plane only. Systematic reviews of nonrandomised comparisons have suggested that MRI without contrast medium might be as accurate as MRI with contrast [8], albeit with some reservations [9]. A recent study of fast MRI (MRI without contrast medium in the axial plane only) performed on a 3-T scanner yielded promising results [10].…”

mentioning

confidence: 99%

Fast Magnetic Resonance Imaging as a Viable Method for Directing the Prostate Cancer Diagnostic Pathway

Padhani

Schoots

Barentsz

2021

European Urology Oncology

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mentioning

confidence: 99%

Fast Magnetic Resonance Imaging as a Viable Method for Directing the Prostate Cancer Diagnostic Pathway

Padhani

Schoots

Barentsz

2021

European Urology Oncology

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“…However, both dynamic contrast enhancement (DCE) and multiplane imaging assessments are part of the PI-RADS standard and are mandatory for other systems that evaluate prostate MRI for the presence of significant cancers [37,38]. It is also important to remember that while multiparametric, multiplane MRI has been extensively clinically validated, bpMRI with single axial imaging plane imaging has not undergone such rigorous evaluations for being able to direct prostate biopsies [14]. With promising studies underway to ascertain the value of bpMRI alone [39], this might change in the future.…”

Section: Methodsmentioning

confidence: 99%

“…Expert readers with good images make more accurate diagnoses with less uncertainty. High levels of expertise also enable the adoption of MRI approaches that avoid contrast medium injections (biparametric MRI; bpMRI) [12][13][14], which can help to increase patient throughput at a lower cost. High reader expertise also minimizes variations [15] in clinically significant cancer yields within the MRI suspicion categories, thus improving the uniformity and reliability of MRI findings for clinical decision-making.…”

Section: Introductionmentioning

confidence: 99%

ESUR/ESUI position paper: developing artificial intelligence for precision diagnosis of prostate cancer using magnetic resonance imaging

et al. 2021

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Artificial intelligence developments are essential to the successful deployment of community-wide, MRI-driven prostate cancer diagnosis. AI systems should ensure that the main benefits of biopsy avoidance are delivered while maintaining consistent high specificities, at a range of disease prevalences. Since all current artificial intelligence / computer-aided detection systems for prostate cancer detection are experimental, multiple developmental efforts are still needed to bring the vision to fruition. Initial work needs to focus on developing systems as diagnostic supporting aids so their results can be integrated into the radiologists’ workflow including gland and target outlining tasks for fusion biopsies. Developing AI systems as clinical decision-making tools will require greater efforts. The latter encompass larger multicentric, multivendor datasets where the different needs of patients stratified by diagnostic settings, disease prevalence, patient preference, and clinical setting are considered. AI-based, robust, standard operating procedures will increase the confidence of patients and payers, thus enabling the wider adoption of the MRI-directed approach for prostate cancer diagnosis. Key Points • AI systems need to ensure that the benefits of biopsy avoidance are delivered with consistent high specificities, at a range of disease prevalence. • Initial work has focused on developing systems as diagnostic supporting aids for outlining tasks, so they can be integrated into the radiologists’ workflow to support MRI-directed biopsies. • Decision support tools require a larger body of work including multicentric, multivendor studies where the clinical needs, disease prevalence, patient preferences, and clinical setting are additionally defined.

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“…It must be also considered, however, that lesions defined as PIRADS 4 by means of contrast enhancement in presence of equivocal cases, could be a distinct form from native PIRADS 4 lesions defined by means of bp sequences, in terms of prevalence of disease significance (Figure 3) (77).…”

Section: B C Amentioning

confidence: 99%

“…It is clear, therefore, that the discrepancy between the results may deeply affect the future clinical management of the patients. It is likely, however, that the described bias depends on the high heterogeneity of the studies, and recent paper of PIRADS Committee also advise caution on pooled test accuracies (77).…”

Section: Literature On Diagnostic Validitymentioning

confidence: 99%

Biparametric (bp) and multiparametric (mp) magnetic resonance imaging (MRI) approach to prostate cancer disease: a narrative review of current debate on dynamic contrast enhancement

et al. 2020

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Prostate cancer is the most common malignancy in male population. Over the last few years, magnetic resonance imaging (MRI) has proved to be a robust clinical tool for identification and staging of clinically significant prostate cancer. Though suggestions by the European Society of Urogenital Radiology to use complete multiparametric (mp) T2-weighted/diffusion weighted imaging (DWI)/dynamic contrast enhancement (DCE) acquisition for all prostate MRI examinations, the real advantage of functional DCE remains a matter of debate. Recent studies demonstrate that biparametric (bp) and mp approaches have similar accuracy, but controversial evidences remain, and the specific potential benefits of contrast medium administration are still poorly discussed in literature. The bp approach is in fact sufficient in most cases to adequately identify a negative test, or to accurately define the degree of aggressiveness of a lesion, especially if larger or with major characteristics of malignancy. This feature would give the DCE a secondary role, probably limited to a second evaluation of the lesion location, for detecting small cancer or in case of controversy. However, DCE has proved to increase the sensitivity of prostate MRI, though a less specificity.Therefore, an appropriate decision algorithm is needed to standardize the MRI approach. Aim of this review study was to provide a schematic description of bpMRI and mpMRI approaches in the study of prostatic anatomy, focusing on comparative validity and current DCE application. Additional theoretical considerations on prostate MRI are provided.

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PI-RADS Committee Position on MRI Without Contrast Medium in Biopsy-Naive Men With Suspected Prostate Cancer: Narrative Review

Cited by 102 publications

References 48 publications

Fast Magnetic Resonance Imaging as a Viable Method for Directing the Prostate Cancer Diagnostic Pathway

Fast Magnetic Resonance Imaging as a Viable Method for Directing the Prostate Cancer Diagnostic Pathway

ESUR/ESUI position paper: developing artificial intelligence for precision diagnosis of prostate cancer using magnetic resonance imaging

Biparametric (bp) and multiparametric (mp) magnetic resonance imaging (MRI) approach to prostate cancer disease: a narrative review of current debate on dynamic contrast enhancement

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