Quantitative Prostate MRI, From the AJR Special Series on Quantitative Imaging

Area of Science:

• Magnetic Resonance Imaging (MRI)
• Oncology
• Radiology

Background:

• Prostate MRI interpretation has historically been qualitative.
• Quantitative MRI biomarkers offer enhanced diagnostic performance.

Purpose of the Study:

• To review quantitative MRI techniques for prostate cancer assessment.
• To highlight the potential of advanced quantitative methods.

Main Methods:

• Apparent Diffusion Coefficient (ADC) from Diffusion-Weighted Imaging (DWI).
• Advanced diffusion techniques: intravoxel incoherent motion, diffusion kurtosis, diffusion tensor imaging, restriction spectrum imaging.
• T1/T2 relaxation times, luminal water imaging, hybrid-multidimensional MRI.
• Dynamic Contrast-Enhanced (DCE) MRI with modified Tofts model.
• Radiomics, texture analysis, and artificial intelligence (AI) for feature refinement.

Main Results:

• ADC from DWI shows strong discriminatory value for clinically significant prostate cancer (csPCa) and recurrence.
• Advanced diffusion techniques promise superior discrimination but are technically complex.
• T1/T2, luminal water imaging, and DCE-MRI provide independent diagnostic information.
• Quantitative size, shape, radiomics, texture analysis, and AI can further refine diagnostic capabilities.

Conclusions:

• Quantitative MRI significantly enhances prostate cancer detection and characterization.
• A range of advanced quantitative techniques show promise for improved accuracy.
• Widespread clinical adoption depends on multi-platform validation and use-case refinement.