Multiparametric MR Imaging in Prostate Cancer Diagnosis: make it easy

This poster is published under an open license. Please read the disclaimer for further details.

Congress:

ECR 2015

Poster Number:

C-1811

Type:

Educational Exhibit

Keywords:

Pelvis, Oncology, MR, MR-Diffusion/Perfusion, Diagnostic procedure, Cancer, Neoplasia

Authors:

G. Popa, C. Scheau, A. Preda, I. G. Lupescu; Bucharest/RO

DOI:

10.1594/ecr2015/C-1811

DOI-Link:

https://dx.doi.org/10.1594/ecr2015/C-1811

Fig. 16: PI-RADS scoring system – T2-wi for the peripheral zone (PZ). MRI examples.

Fig. 17: PI-RADS scoring system – T2-wi for the transition zone (TZ). MRI examples.

Fig. 12: Dynamic Contrast-Enhanced MRI. The central gland is enlarged with well defined...

Fig. 13: Dynamic Contrast-Enhanced MRI (the same patient as in Fig.12). The region of...

Fig. 21: PI-RADS scoring system - DWI and ADC map. T2-wi: hypointense tumoral nodule...

Fig. 22: T2 stage. T2-wi: small hypointense tumoral nodule located in the right PZ...

Fig. 23: T3a stage. Hypointense tumoral lesion located in the right PZ (arrows) with...

Fig. 24: T3b stage. Hypointense tumoral lesion located in the left PZ (arrows) with...

Fig. 25: T4 stage. Prostate tumor invading both seminal vesicles (blue arrows) and...

Learning objectives

- To describe the basic MRI semiology of prostate cancer indicating the advantages and limitations of each sequence used and to elaborate an optimal MRI protocol. - To explain how to use the Prostate Imaging and Reporting Archiving Data System (PI-RADS).

Background

- Prostate cancer is one of the most common malignancies in men, generally with a slow growth rate and early detection is essential for a complete treatment [1]. - The diagnosis is mainly based on digital rectal examination (DRE), serum prostate specific antigen (PSA) and trans-rectal ultrasound (TRUS) guided systematic random prostate biopsy, but cancer located outside the routine biopsy zone may be missed [1-3]. Currently, an accurate detection and localization of prostate cancer can be done easily using multip-parametric MRI (mp-MRI) examination which is...

Findings and procedure details

Procedure details - Based on the recommendations of the European Society of Urogenital Radiology (ESUR) we use the following MR protocol to investigate prostate cancer on a 1.5 T MRI unit with the body coil. We recommend the use of anti-peristaltic drugs. We also recommend using the same scan parameters for acquisitions in the axial plane for a proper evaluation of the prostate: thickness, spacing, matrix and FOV. - T2-wi sagittal through the entire pelvis. Sequences included: type FSE JET, TR = 5907 ms, TE...

Conclusion

- Conventional sequences are useful to evaluate prostate cancer in the peripheral zones. - DWI and DCE extent the MR diagnostic accuracy particularly in central and anterior fibromuscular stroma zones. - Multiparametric MRI can provide superior informations regarding detection and staging in prostate cancer, including extra-capsular extension. ACKNOWLEDGEMENT: This work received financial support through the project entitled "CERO – Career profile: Romanian Researcher", grant number POSDRU/159/1.5/S/135760, cofinanced by the European Social Fund for Sectoral Operational Programme Human Resources Development 2007-2013.

Personal information

Dr. Popa Gelu-Adrian [email protected] Fundeni Clinical Institute, Department of Radiology “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania

References

1. Young Jun Choi, Jeong Kon Kim, Namkug Kimet al. Functional MR Imaging of Prostate Cancer, RadioGraphics 2007; 27:63–77; Published online 10.1148/rg.271065078 2. J. O. Barentsz, J.Richenberg, R. Clements et al. ESUR prostate MR guidelines 2012, European Radiology, vol. 22,no. 4, pp.746–757, 2012; DOI 10.1007/s00330-011-2377-y 3. Caroline M. A. Hoeks, Jelle O. Barentsz, Thomas Hambrock et al. Prostate Cancer: Multiparametric MR Imaging for Detection, Localization, and Staging, Radiology: Volume 261, 2011; 46-66 4. M. Röthke, D. Blondin, H.-P. Schlemmer, T. Franiel PI-RADS Classification: Structured Reporting...