PIRADS. Imaging Atlas of main findings on multiparametric Prostate MRI.

Congress:

ECR 2019

Poster Number:

C-3176

Type:

Educational Exhibit

Keywords:

Psycho-oncology, Image registration, Cancer, Surgery, Comparative studies, MR, Pelvis, Oncology

Authors:

M. RELAÑO MESA¹, M. G. Rueda Monago¹, V. Arroyo Fernández², C. Gil Perea¹, P. Fernández Tejado¹, A. Lopez Moreno¹, S. Fernández Gómez¹, M. Rabelo Fernández¹, M. V. González Ibañez¹; ¹BADAJOZ/ES, ²Cádiz/ES

DOI:

10.26044/ecr2019/C-3176

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-3176

Table 1: PI-RADS™ v2 Assessment Categories.

Fig. 3: TNM-staging in prostate cancer.

Fig. 4: PI-RADS v2 score por the peripheral zone.

Fig. 5: PI-RADS 1. Peripheral Zone. A) b800DWI, B) ADC map. No abnormality seen on DWI...

Learning objectives

Review the Prostate Imaging Reporting and data system (PIRADS) guidelines for multi-parametric Magnetic Resonance Imaging (mpMRI), and provide an imaging Atlas of mpMRI performed in our hospital. Describe the signs associated with extracapsular extension of Prostate Cancer, since they are essential in tumor staging.

Background

Theprostate glandis part of the male reproductive system and is the largest male accessory gland.It typically weighs between 20-40 grams with an average size of 3 x 4 x 2 cm. The prostate is comprised of 70% glandular tissue and 30% fibromuscular or stromal tissue. NORMAL ANATOMY From superior to inferior the prostase is formed: The base (just below the urinary bladder). The midgland. The apex. It is divided into four histologic zones (fig. 1): - Theperipheral zone represents approximately 70% of the prostate gland....

Findings and procedure details

MpMRI: MpMRI is the method of choice to evaluate the prostate in clinically significant adenocarcinoma. Images are obtained using a multiparametric technique including High-resolution T2 weighted images, a dynamic contrast study (DCE), and DWI.Secuences T1W-images determine the presence of post-biopsy hemorrhage. Indications MpMRI in prostate gland (fig.2): The principal indication for MRI of the prostate is in the evaluation of prostate cancer after an ultrasound guided prostate biopsy has confirmed cancer in order to determine if there is extrcapsular extension. MRI is also being used...

Conclusion

MRI is recognized to be the best imaging method in local tumor staging of prostate cancer. Radiologists must be familiar with PI-RADS and with MRI signs associated with extracapsular extension, since they are key in clinical management and treatment.

Personal information

References

Prostate Imaging Reporting & Data System - PI-RADS 2015 version2 (full text document) ACR American College of Radiology PI-RADS Prostate Imaging – Reporting and Data System: 2015, Version 2 Weinreb JC, Barentsz JO et al. European Urology 2016 (69), 16-40. Prostate cancer: diagnosis, parametric imaging and standardized report. Puech P et al. Diagn Interv Imaging. 2014 Jul-Aug;95(7-8):743-52 Multiparametric-MRI in diagnosis of prostate cancer Prostate Cancer Staging Quickreferences in PDF of the American Joint Committee on Cancer, 7th edition Prostate cancer: Oncology guidelines of the European...