Reading MRI of the Prostate. A Practical Guide

Description

Contents Contributors About the Book About the Editors 1: Introduction References 2: Normal Anatomy of Prostate Normal MR Appearances of Various Zones Other Relevant Anatomy Checklist for Anatomy (on T2 Weighted Images) References 3: Prostate MRI: Technique and Sequences Pre-procedure Clinical Information Timing of MRI Examination Patient Preparation Magnetic Field Strength and Coils mpMRI Exam Protocol Anatomic T1 Weighted and T2 Weighted Images Diffusion Weighted Imaging (DWI) with Apparent Diffusion Coefficient (ADC) Maps Dynamic Contrast Enhanced (DCE)-MRI Diagnostic Accuracy of mpMRI of Prostate References 4: Multiparametric MRI of Prostate: Analysis and Recommendations of Prostate Imaging Reporting and Data System (PI-RADS) Version 2.1 Sequence Assessment T2 Weighted Images Diffusion Weighted Imaging with Apparent Diffusion Coefficient Map DCE-MRI Putting It Together: PI-RADS v2.1 Overall Assessment Overall PI-RADS v2 Assessment in Case of Inadequate Diffusion Weighted Imaging Overall PI-RADS v2 Assessment for Peripheral Zone Lesions in Case of Non-contrast Biparametric MR Exam Caveats in PI-RADS v2 Assessment and Updates in v2.1 Assessment MR Staging of Prostate Cancer MR Criteria for Extra-Prostatic Extension [11, 12] (Figs. 4.17 and 4.18) MR Criteria for Seminal Vesicle Invasion [11, 12] (Fig. 4.19) Reporting Template and Mapping Review and Limitations of PI-RADS v2 References 5: Biparametric MRI of Prostate: Can We Shorten the MR Imaging Protocol? Introduction Rationale for a Shortened Biparametric Protocol Representative MRI Protocols: Biparametric vs. Multiparametric Advantages Using a Biparametric Protocol Time Savings Using a Biparametric Protocol No Need for Intravenous Contrast Agents Cost Savings Using a Biparametric Protocol Diagnostic Accuracy Using a Biparametric Protocol Diagnostic Accuracy Compared to mp-MRI Diagnostic Accuracy for Clinical Significant Cancer Potential Drawbacks/Challenges of Biparametric-MRI Loss of Potential Upgrade from PI-RADS Category 3 to 4 in the Peripheral Zone Influence on Inter-Reader Agreement Heterogeneity in Image Acquisition and Image Quality Potential Recall Exams in Certain Patients Summary/Conclusion References 6: MRI Appearance of Prostate Cancers in Locations Posing Diagnostic or Biopsy Challenges Peripheral Zone Locations Other Than Peripheral Zone References 7: Tumor Mimics: Benign Conditions that Mimic Prostate Cancer Normal Structures that May Be Mistaken for Prostate Cancer Benign Conditions that May Be Mistaken for Prostate Cancer References 8: The Value of Incorporating Multiparametric MRI for Active Surveillance in Patients with Prostate Cancer Current Standard of Care (SOC) for Active Surveillance Challenges with the Current SOC for AS and the Utility of Prostate MRI Under-Sampling of the Prostate with TRUS-Guided Biopsy Necessity for Repeat Biopsy Non-tracking Systematic Biopsy in Active Surveillance Biopsy Reclassification on Active Surveillance Anxiety References 9: A Primer on Prostate MRI for the Practicing Urologist: Update on the Current Literature Clinical Utility of MRI Prominent Studies Associated with mpMRI PIVOT (Prostate Cancer Intervention Versus Observation Trial) ProtecT PROMIS (Diagnostic Accuracy of Multi-Parametric MRI and TRUS Biopsy in Prostate Cancer) PRECISION (Prostate Evaluation for Clinically Important Disease: Sampling Using Image Guidance or Not?) 4M (Met Prostaat MRI Meer Mans) MRI-FIRST (Use of Prostate Systematic and Targeted Biopsy on the Basis of Multiparametric MRI in Biopsy-Naive Patients) Making Sense of the Data for a Urologist References 10: Quantitative Imaging of Prostate: Scope and Future Directions Quantitative Sequences Diffusion Weighted Imaging (DWI) with Apparent Diffusion Coefficient (ADC) Mapping DCE-MRI with Perfusion Modeling Relaxometry Clinical Utility of Quantitative Assessment: Present Evidence and Future Directions Predicting Aggressiveness of Prostate Cancer Differentiating Prostatitis from Prostate Cancer Follow-up Assessment in Patients on Active Surveillance Summary References Index