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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound

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Arguments against using an abbreviated or biparametric prostate MRI protocol

Felipe B Franco1, Fiona M Fennessy2,3

  • 1Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, 75 Francis Street, Boston, MA, 02215, USA.

Abdominal Radiology (New York)
|March 15, 2020
PubMed

Insights

Dynamic contrast-enhanced (DCE) MRI enhances prostate cancer detection and staging within the PI-RADS framework. This abbreviated MRI approach improves the identification of clinically significant prostate cancer.

Area of Science:

  • Radiology
  • Oncology
  • Medical Imaging

Background:

  • Abbreviated or biparametric prostate MRI protocols, often omitting dynamic contrast-enhanced (DCE) MRI, are gaining traction for detecting clinically significant prostate cancer.
  • The PI-RADS (Prostate Imaging Reporting and Data System) lexicon is a widely used standard for interpreting prostate MRI findings.

Purpose of the Study:

  • To elucidate the benefits of incorporating DCE-MRI into the PI-RADS lexicon for prostate cancer detection.
  • To highlight the value of triplanar T2-weighted imaging.
  • To discuss the utility of multiparametric MRI (mpMRI) in prostate cancer staging, recurrence evaluation, and assessing neoadjuvant therapy response.

Main Methods:

  • Review and discussion of the role of DCE-MRI within the PI-RADS V2 guidelines.
  • Analysis of PI-RADS V2 category 3 peripheral zone lesions.
  • Examination of triplanar T2-weighted imaging benefits.
  • Evaluation of mpMRI applications in staging, recurrence detection, and therapy response assessment.

Main Results:

  • DCE-MRI provides crucial information, particularly for PI-RADS V2 category 3 lesions in the peripheral prostate zone.
  • Triplanar T2-weighted images offer significant advantages in prostate MRI interpretation.
  • Multiparametric MRI is beneficial for comprehensive prostate cancer management.

Conclusions:

  • Dynamic contrast-enhanced MRI is a valuable component of multiparametric MRI for prostate cancer detection and characterization.
  • The integration of DCE-MRI and triplanar T2-weighted imaging refines the PI-RADS assessment.
  • Multiparametric MRI plays a critical role in staging, monitoring recurrence, and evaluating treatment efficacy in prostate cancer.

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