Predictive value of MRI in the localization, staging, volume estimation, assessment of aggressiveness, and guidance of radiotherapy and biopsies in prostate cancer

Abstract

Multiparametric magnetic resonance imaging (MRI) has the potential of being the ideal prostate cancer (PCa) assessment tool. Information gathered with multiparametric MRI can serve therapy choice, guidance of interventions, and treatments. The purpose of this review is to discuss the potential role of multiparametric MRI in focal therapy with respect to patient selection and directing (robot‐guided) biopsies and intensity‐modulated radiation therapy (IMRT). Multiparametric MRI is a versatile and promising technique. It appears to be the best available imaging technique at the moment in localizing, staging (primary as well as recurrent disease, and local as well as distant disease), determining aggressiveness, and volume of PCa. However, larger study populations in multicenter settings have to confirm these promising results. However, before such studies can be performed more research is needed in order to achieve standardized imaging protocols. J. Magn. Reson. Imaging 2012;35:20‐31. © 2011 Wiley Periodicals, Inc.

Preoperative mp-MRI of the prostate provides little information about staging of prostate carcinoma in daily clinical practice

“…Sensitivity and specificity for the detection of extracapsular growth are reported in the range from 13 to 95 % and 49 to 97 %. For the prediction of N + disease, sensitivity and specificity vary between 23 and 80 % and 81 and 99 %, respectively [18]. Our results are at the low end of these ranges, with a sensitivity of 30 % for the detection of ECE.…”

Histogram analysis of diffusion kurtosis magnetic resonance imaging in differentiation of pathologic Gleason grade of prostate cancer

“…Therefore, to preoperatively distinguish low GS from high GS cancer would be a major advance and would have a significant benefit for individualized treatment options. Recently, advances in magnetic resonance imaging (MRI) of prostate with diffusion-weighted imaging (DWI) have resulted in greater ability in determination of localized PCa and prediction of its pathologic Gleason grade [5][6][7][8][9]. The correlations between GS of PCa and apparent diffusion coefficients (ADCs) obtained from DWI have been strongly shown by histopathologic-radiologic studies, and the studies have explained it as a result of increased cellularity in high GS tumor [10][11][12].…”

Pilot Study of the Use of Hybrid Multidimensional T2-Weighted Imaging–DWI for the Diagnosis of Prostate Cancer and Evaluation of Gleason Score

“…Multiparametric MRI—a combination of T2-weighted imaging, DWI, and dynamic contrast-enhanced MRI (DCE-MRI)—is commonly used for the diagnosis, local staging, and detection of prostate cancer [1–7]. T2-weighted and DW images are the backbone of this protocol [8, 9].…”