Multiparametric Magnetic Resonance Imaging for the Detection of Clinically Significant Prostate Cancer: What Urologists Need to Know. Part 1: Acquisition

Congress:

ECR 2020

Poster Number:

C-07755

Type:

Educational Exhibit

Keywords:

Quality assurance, Education and training, Artifacts, Technical aspects, Imaging sequences, Diagnostic procedure, MR-Diffusion/Perfusion, MR, Radiographers, Oncology, Genital / Reproductive system male, MRI, Not applicable

Authors:

R. R. M. Engels¹, B. Israel¹, A. R. Padhani², J. O. Barentsz¹; ¹Nijmegen/NL, ²Northwood, Middlesex/UK

DOI:

10.26044/ecr2020/C-07755

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-07755

Fig. 1: Magnetic field strength 3T MRI vs 1.5T MRI. 1A and 1B. 3T-axial and coronal...

Fig. 2: ERC vs non-ERC MRI of the prostate. This image shows a patient who underwent a...

Fig. 3: Rectum catheter vs no rectum catheter. This image shows a patient who...

Fig. 4: Angulation of the coronal plane. A. Angulation of the coronal plane (yellow...

Learning objectives

To show how image acquisition of prostate multiparametric Magnetic Resonance Imaging (mpMRI) can be optimized. To provide a summary of recommendations for the acquisition of prostate mpMRI To understand the different factors that influence the image quality of prostate mpMRI

Background

The success of multiparametric magnetic resonance imaging (mpMRI) for reliably detecting and localizing clinically significant (cs) prostate cancer (PCa) is highly dependent on image quality [1-4]. Due to the variability of available MRI equipment including software levels and prostate MRI radiographers’ experience, it can be challenging to consistently achieve good-quality images. The European Society of Urogenital Radiology (ESUR) published the Prostate Imaging Reporting and Data System (PI-RADS) guidelines, which included recommendations on minimal and optimal requirements for prostate mpMRI[5-7]. However, these requirements are only technical...

Findings and procedure details

Magnetic field strength: One of the most frequently discussed topics of prostate mpMRI is whether to use 1.5T or 3T MRI field strength. A comparison between the 1.5T and 3T MRI by Ullrich et al. [8] showed: T2-weighted images (T2WI): Comparable “signal-to-noise” (SNR) and “contrast-to-noise” (CNR) Diffusion-weighted images (DWI): SNR and CNR significantly lower at 1.5T An example of 1.5T versus 3T MRI of the prostate in the same patient is shown in Fig. 1. Gradient strength: The SNR and CNR are dependent on the...

Conclusion

It is essential that mpMRI scans are PI-RADS v2 compliant and are performed by trained MRI radiographers using a standardized protocol consisting of T2WI, DWI, and DCE-MRI. Proper patient preparation and prostate MRI–trained radiographers are essential for optimal image quality, and thereby increasing the diagnostic value. It is essential to make patients feel comfortable, with clear instructions and communication before and during the scanning procedure. The use of antispasmodics is recommended, as well as removing air from the rectum where possible. Artifacts can still degrade...

Personal information and conflict of interest

R.R.M. Engels; Nijmegen/NL - nothing to disclose B. Israel; Nijmegen/NL - nothing to disclose A. R. R. Padhani; Northwood, Middlesex/UK - nothing to disclose J. O. Barentsz; Nijmegen/NL - Advisory Board at SPL Medical and Soteria Medical