Roundtable: arguments in support of using multi-parametric prostate MRI protocol.

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Multi-parametric MRI (mpMRI) is standard for prostate cancer assessment.
• Dynamic Contrast Enhancement (DCE) is a component of mpMRI.
• Bi-parametric MRI (bpMRI) omits DCE, simplifying the protocol.

Purpose of the Study:

• To review the specific value of the DCE sequence in prostate MRI.
• To evaluate scenarios where DCE remains beneficial.
• To assess the safety profile of DCE agents.

Main Methods:

• Literature review of studies comparing bpMRI and mpMRI.
• Analysis of DCE utility in specific clinical situations.
• Review of adverse event data for IV gadolinium agents.

Main Results:

• DCE can resolve equivocal prostate MRI findings.
• DCE enhances diagnostic accuracy, particularly for less experienced readers.
• DCE aids in rescuing prostate MRI exams with suboptimal T2W and DWI sequences.
• DCE is effective in detecting biochemical recurrence.
• Group II IV gadolinium agents have a favorable safety profile.

Conclusions:

• DCE-sequence inclusion in prostate MRI offers significant value in select scenarios.
• bpMRI may not be suitable for all cases, and DCE can be judiciously applied.
• The benefits of DCE in specific situations outweigh the minimal risks associated with modern IV contrast agents.