Prostate gland multiparametric resonance. From guidelines to practice.

Congress:

ECR 2018

Poster Number:

C-2167

Type:

Educational Exhibit

Keywords:

MR, Oncology, MR-Functional imaging, Diagnostic procedure, Education, Cancer, Education and training

Authors:

C. Gómez ¹, L. A. Ruiz Elizondo²; ¹México /MX, ²Mexico City/MX

DOI:

10.1594/ecr2018/C-2167

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-2167

Fig. 1: TW2 sagittal, midline prostate gland

Fig. 14: T2WI A. Sagittal midline. B. axial towards the base.

Fig. 16: Patient 1 TZ evaluation, lesion #2, Gland base A. axial T2WI B. ADC C. DCE D....

Fig. 3: mpMRI of different patients Axial T1WI (A) T2WI (B) coronal T2WI (C) ADC (D)...

Fig. 20: Patient 3 A. T2WI B. ADC C.DCE D. Fused T2W/DCE E. sagittal T2WI F. Sector map....

Fig. 27: Patient 6. A. T2WI B. ADC C.DCE D. And E. Coronal T2WI, F. Sector map.

Learning objectives

To review the study indications and patient preparation prior to the test. To learn the MRI sequences required for the testand lesion classification criterion following the PI-RADS v2 system. To adopt a systematic approach for the multiparametric prostate resonance (mpMRI) analysis to build a solid report.

Background

Prostate cancer is one of the most prevalent malignant neoplasms worldwide, incidence being higher in older patients2. It represents the second leading cause of death. In underdeveloped countries, most of the tumours are diagnosed in advanced stages, moment in which therapy success is low2. Magnetic resonance is a non invasive imaging method for evaluating the prostate gland and surrounding structures. Amultiparametric protocol (mpMRI) allows better detection of clinically significant cancer, as well as differentiating benign from dormant malignancies. Its main goals being the reduction of...

Findings and procedure details

A review of prostate glandmpMRIsperformed in our institution (CT Scanner) from January 2015 to may 2017 was conducted, selecting a few representative patients to present a case-based PI-RADS review. International articles and the PI-RADS v2 guidelines were consulted. PI-RADS v2 1 5-point scale based classification. A 39 sections anatomical map should be used for lesion localization. The mpMRI assessment category indicates the probability of correlation to clinically significant prostate gland cancer in a specific sector. Clinically significant cancer is defined (pathology) as: Gleason >7 (including...

Conclusion

Prostate gland cancer is the second most common neoplasm in the world. Nowadays, mpMRI has become the method of choice for detecting and staging prostatic cancer, as it offers high resolution imaging and allows the evaluation of locoregional extension, lymph node affection and detection of bone metastasis. mpMR is conformed by T2WI, DWI and dynamic T1WI acquisitions. T2WI gain greater importance in transitional zone lesions whilst DWI/ADC evaluation in peripheral zone pathology. The goal of the PI-RADS 2 reporting system is the standardization of prostate...

Personal information

Contact details: Dra Claudia Gómez PET/CT attendant. CT Scanner del Sur, CdMx, Mexico Doppler ultrasound fellow resident. Departament of Radiology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, CdMx, Mexico e-mail [email protected] Dr Luis Alberto Ruiz Elizondo PET/CT attendant.CT Scanner del Sur, CdMx, Mexico MRI section Dra Laura Quiroz MRI chief physician. CT Scanner del Sur, CdMx, Mexico

References

PI-RADS Prostate Imaging-Reporting and Data system: 2015, version 2. American College of Radiology Prevención y detección temprana del cáncer de próstata en el primer nivel de atención. Secretaria de Salud 21/Marzo/2013 Steiger P, Thoeny H. Prostate MRI based on PI-RADS version 2: how we review and report. Cancer imaging 2016;16:9 Barentsz J, Weinreb J, Verma S, Thoeny H, Tempany C, Shtern F, Pdhani A, Margolis D, Macura K, Haider M, Cornud F, Choyke P. Synopsis of the PI-RADS v2 Guidelines for multiparametric prostate magnetic resonance...