Biparametric Prostate MRI: A Practical Approach to Implementation and Comparative Analysis

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Prostate cancer (PCa) is a major global health concern.
• Multiparametric MRI (mpMRI) is the standard for PCa detection but has safety and cost drawbacks.
• Biparametric MRI (bpMRI) offers a DCE-free alternative, retaining key imaging sequences.

Purpose of the Study:

• To critically review bpMRI's technical aspects, diagnostic performance, and clinical utility.
• To compare bpMRI directly with mpMRI for prostate cancer diagnosis.
• To identify limitations and future research directions for bpMRI.

Main Methods:

• Literature review and critical analysis of existing studies on bpMRI and mpMRI.
• Evaluation of diagnostic metrics such as sensitivity, specificity, and negative predictive value for clinically significant PCa (csPCa).
• Assessment of safety, cost-effectiveness, and workflow implications.

Main Results:

• bpMRI demonstrates potential for detecting csPCa with advantages in patient safety, cost, and scan time.
• Challenges include protocol variability, need for large-scale validation, and potential for missing subtle lesions.
• bpMRI shows comparable performance to mpMRI in select settings.

Conclusions:

• bpMRI is a promising, efficient imaging tool for prostate cancer management.
• Standardization of protocols, AI integration, and multi-center trials are crucial for clinical adoption.
• bpMRI may complement or replace mpMRI in specific patient populations.