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Updated: Oct 27, 2025
Use of MRI-ultrasound Fusion to Achieve Targeted Prostate Biopsy
Published on: April 9, 2019
[Clinical impact of abbreviated unenhanced prostate protocols in magnetic resonance imaging]
Olga Solyanik1, Maurice Heimer2
1Klinik und Poliklinik für Radiologie, LMU-Klinikum, Marchioninistraße 15, 81377, München, Deutschland. Olga.solyanik@med.uni-muenchen.de.
Background:
According to the Prostate Imaging Reporting and Data System (PI-RADS) v2.1 multiparametric magnetic resonance imaging (mpMRI) with gadolinium-(Gd)-based contrast agents is the diagnostic standard of care in the detection of prostate cancer (PCa). Recent data suggest equivalent performance of biparametric MRI (bpMRI) and mpMRI in defined indications.
Objectives:
Evaluation of the current role of abbreviated or unenhanced protocols in MRI of the prostate in various clinical settings.
Materials And Methods:
Evaluation of clinical trials, guidelines and expert opinions.
Results:
The use of dynamic contrast-enhanced (DCE) MRI sequences is associated with contrast agent-associated risks and has significant impact on the imaging procedure and costs. Arguments for and against the use of contrast agent in prostate protocols as well as equivalence from bpMRI and mpMRI are discussed.
Conclusions:
Currently, bpMRI can only be performed if very good image quality is available and in the hands of a radiologist with extensive experience in reading prostate MRI. There is a need for prospective studies to qualify bpMRI as the diagnostic method for the primary diagnosis of PCa.
Insights
Biparametric MRI (bpMRI) may be equivalent to multiparametric MRI (mpMRI) for prostate cancer detection, potentially reducing risks and costs associated with contrast agents. Further studies are needed to establish bpMRI as a primary diagnostic tool.
Area of Science:
- Radiology
- Oncology
- Medical Imaging
Background:
- Prostate Imaging Reporting and Data System (PI-RADS) v2.1 establishes multiparametric MRI (mpMRI) with contrast agents as the standard for prostate cancer (PCa) detection.
- Emerging data indicate biparametric MRI (bpMRI) may offer comparable performance to mpMRI in specific clinical scenarios.
Purpose of the Study:
- To evaluate the role of abbreviated or unenhanced MRI protocols for prostate cancer diagnosis.
- To assess the clinical utility of bpMRI versus mpMRI in various settings.
Main Methods:
- Systematic review of clinical trials.
- Analysis of current guidelines and expert opinions.
- Comparative evaluation of MRI protocols.
Main Results:
- Dynamic contrast-enhanced (DCE) MRI sequences carry contrast agent-associated risks and increase procedure costs.
- The study discusses arguments for and against contrast agent use in prostate MRI.
- Equivalence in performance between bpMRI and mpMRI is explored.
Conclusions:
- Biparametric MRI (bpMRI) requires high image quality and radiologist expertise.
- Prospective research is necessary to validate bpMRI for primary prostate cancer diagnosis.
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Description of the Procedures
Computed Tomography (CT) scan:
Computed Tomography (CT) scans use X-ray technology to generate detailed images of bones, organs, and tissues. During the scan, the patient lies on a moving table...