Mp mri prostate

• Article • 06 May 2022 PSA density is complementary to prostate MP-MRI PI-RADS scoring system for risk stratification of clinically significant prostate cancer • • • • • • • • • ORCID: orcid.org/0000-0002-7088-1910 • • • … • ORCID: orcid.org/0000-0002-4484-6820 Show authors Prostate Cancer and Prostatic Diseases volume 26, pages 347–352 ( 2023) Background While prostate multiparametric-magnetic resonance imaging (MP-MRI) has improved the diagnosis of clinically significant prostate cancer (CSPC), the complementary use of prostate-specific antigen (PSA) levels to risk-stratify for CSPC requires further study. The objective of this project was to determine if prostate MP-MRI and PSA can provide complementary insights into CSPC risk stratification. Methods In an IRB-approved study, pathologic outcomes from patients who underwent MR/US fusion-targeted prostate biopsy were stratified by various parameters including PSA, PSA density (PSAD), age, race, and PI-RADS v2 score. CSPC was defined as a Gleason score ≥7. Logistic regression was used to determine odds ratios (OR) with 95% confidence intervals (CI). P values were reported as two-sided with p< 0.05 considered statistically significant. ROC curves were generated for assessing the predictive value of tests and sensitivity + specificity optimization was performed to determine optimal testing cutoffs. Results A total of 327 patients with 709 lesions total were analyzed. PSAD and PI-RADS scores provided complementary predictive...

• Review Article • 17 July 2019 Multiparametric MRI for prostate cancer diagnosis: current status and future directions • ORCID: orcid.org/0000-0002-3700-0069 • ORCID: orcid.org/0000-0001-5218-6431 • • • • • • ORCID: orcid.org/0000-0003-4230-0338 • • … • Show authors Nature Reviews Urology volume 17, pages 41–61 ( 2020) The current diagnostic pathway for prostate cancer has resulted in overdiagnosis and consequent overtreatment as well as underdiagnosis and missed diagnoses in many men. Multiparametric MRI (mpMRI) of the prostate has been identified as a test that could mitigate these diagnostic errors. The performance of mpMRI can vary depending on the population being studied, the execution of the MRI itself, the experience of the radiologist, whether additional biomarkers are considered and whether mpMRI-targeted biopsy is carried out alone or in addition to systematic biopsy. A number of challenges to implementation remain, such as ensuring high-quality execution and reporting of mpMRI and ensuring that this diagnostic pathway is cost-effective. Nevertheless, emerging clinical trial data support the adoption of this technology as part of the standard of care for the diagnosis of prostate cancer. • Multiparametric MRI (mpMRI) of the prostate is a novel promising tool for diagnosis of prostate cancer that might help to reduce overdiagnosis of insignificant prostate cancer. • mpMRI should include four sequences: T1-weighted images, T2-weighted images, diffusion-weighted i...

Objectives National guidelines recommend prostate multiparametric (mp) MRI in men with suspected prostate cancer before biopsy. In this study, we explore prostate mpMRI protocols across 14 London hospitals and determine whether standardisation improves diagnostic quality. Methods An MRI physicist facilitated mpMRI set-up across several regional hospitals, working together with experienced uroradiologists who judged diagnostic quality. Radiologists from the 14 hospitals participated in the assessment and optimisation of prostate mpMRI image quality, assessed according to both PiRADSv2 recommendations and on the ability to “rule in” and/or “rule out” prostate cancer. Image quality and sequence parameters of representative mpMRI scans were evaluated across 23 MR scanners. Optimisation visits were performed to improve image quality, and 2 radiologists scored the image quality pre- and post-optimisation. Results 20/23 mpMRI protocols, consisting of 111 sequences, were optimised by modifying their sequence parameters. Pre-optimisation, only 15% of T2W images were non-diagnostic, whereas 40% of ADC maps, 50% of high b-value DWI and 41% of DCE-MRI were considered non-diagnostic. Post-optimisation, the scores were increased with 80% of ADC maps, 74% of high b-value DWI and 88% of DCE-MRI to be partially or fully diagnostic. T2W sequences were not optimised, due to their higher baseline quality scores. Conclusions Targeted intervention at a regional level can improve the dia...

Prostate Cancer Prostate cancer is a tumor of the prostate gland, which is located in front of the rectum, below the bladder and above the base of the penis. Your doctor may perform a physical exam, prostate-specific antigen (PSA) blood test or digital rectal exam to help diagnose your condition. If cancer is detected, your doctor may use prostate ultrasound or prostate MRI to help determine its extent and where to perform a biopsy. An ultrasound- or MRI-guided needle biopsy may be performed to confirm the diagnosis. Treatment options include surgery, radiation therapy, systemic therapy, and active surveillance. What is prostate cancer? Prostate cancer is a tumor of the prostate. The gland sits in front of the rectum, above the base of the penis, and below the Prostate cancer is the most common form of cancer in American men. It is most prevalent in men over age 65 and common in men 50-64 years old. However, prostate cancer can occur in men younger than 50. Prostate-specific antigen (PSA) screening has dramatically improved the diagnosis of prostate cancer. As a result, men below the age of 65 years show an increased incidence of this disease. Risk factors of prostate cancer include: • Age • Race, especially men of African American descent • Obesity • Family history of prostate cancer • Diet high in fats from red meat • History of sexually transmitted disease (STD) Prostate cancer shows few symptoms until its advanced stages. These symptoms include: • Blood in urine or sem...

Purpose of Review To provide the radiologist with basic knowledge about normal and abnormal findings in the prostatic mp-MRI, taking a look at the possible diagnostic pitfalls commonly seen in daily clinical practice, allowing him to recognize and consequently avoid them. Recent Findings Prostate mp-MRI has now become commonly used in most diagnostic imaging centers, as a precise, accurate and above all non-invasive tool, useful in the diagnosis, staging and follow-up of prostate diseases, first of all prostatic carcinoma. For this reason, it is important to take into account the existence of numerous possible anatomic and pathologic processes which can mimick or masquerade as prostate cancer. Summary Through the combination of anatomical (T2WI) and functional sequences (DWI/ADC and DCE), the mp-MRI of the prostate provides all the information necessary for a correct classification of patients with prostate disease, cancer in particular. It is not uncommon, however, for the radiologist to make errors in the interpretation of imaging due to conditions, pathological or otherwise, that mimic prostate cancer and that, consequently, affect the diagnostic/therapeutic process of patients. The strategy, and what this pictorial review aims at, is to learn to recognize the potential pitfalls of the prostatic mp-MRI and avoid them. Nowadays, the use of mp-MRI in the diagnosis, staging and therapeutic management of prostate cancer has become very common and widespread. It is well know...

MultiParametric MRI (mpMRI): The 3D Prostate MRI Scan MultiParametric MRI (mpMRI): The 3D Prostate MRI Scan What is mpMRI of the prostate? Multiparametric magnetic resonance imaging (mpMRI) of the prostate is a cutting edge diagnostic tool that uses four imaging parameters, instead of one, to identify healthy and unhealthy prostate tissue. It generates a 3D prostate map, detects water diffusion in prostate and abnormal tissue, and evaluates blood flow in tumor and normal tissues. What are the benefits of mpMRI? Unlike ultrasound procedures, mpMRI is completely noninvasive. The powerful 3T magnet eliminates the need to insert a wand into the rectum, making the procedure more comfortable. Clearer image quality from the MRI scan shows tumors less than a centimeter in size. Biopsies can sometimes be avoided when mpMRI findings support clinical features. When cancer is suspected, mpMRI provides image guidance. These "fused MRI-Ultrasound image guided" biopsies have been found to be more accurate than "blind" biopsies. Who is a good mpMRI candidate? This MRI scan is a good option for men with rising or abnormally high prostate-specific antigen (PSA). Men with low cancer risk considering active surveillance can use mpMRI to establish a baseline for future test comparisons. Additionally, mpMRI can also help determine treatment success or recurrence in men who have already received prostate cancer therapy. How should I prepare for the procedure? Please refrain from eating three hou...

Purpose of Review To highlight the recent evidence about the use of mp-MRI in the local staging of prostate cancer, enhancing the potential benefits compared to the known and more invasive canonical staging methods. Recent Findings Multiparametric magnetic resonance (mp-MRI) plays a key role not only in diagnosis, but also in local staging of prostate cancer, as it can assess with high accuracy the extracapsular extension of the tumor, invasion of seminal vesicles, the involvement of lymph nodes and the presence of possible bone metastases. Summary Prostate cancer is currently the most common male cancer in Europe and it is associated with a high mortality rate, which is why it is necessary to make an early and accurate diagnosis. Firstly, it is important to distinguish between a disease confined to the gland and a disease with a loco regional or remote extension, since neoplastic staging is the starting point for risk stratification, prognosis and therapeutic planning. According to the PI-RADS guidelines v 2.1 the main mp-MRI sequences necessary to obtain a complete and accurate resonance imaging are the T2-weighted sequences (T2WI), which represent the pivotal morphological sequences for local staging, together with the diffusion-weighted imaging (DWI) and dynamic sequences acquired after intravenous contrast medium administration (DCE). However, due to some limitations, mp-MRI does not have the same diagnostic power in the evaluation of lymph nodes, for which the gold s...

• Article • 06 May 2022 PSA density is complementary to prostate MP-MRI PI-RADS scoring system for risk stratification of clinically significant prostate cancer • • • • • • • • • ORCID: orcid.org/0000-0002-7088-1910 • • • … • ORCID: orcid.org/0000-0002-4484-6820 Show authors Prostate Cancer and Prostatic Diseases volume 26, pages 347–352 ( 2023) Background While prostate multiparametric-magnetic resonance imaging (MP-MRI) has improved the diagnosis of clinically significant prostate cancer (CSPC), the complementary use of prostate-specific antigen (PSA) levels to risk-stratify for CSPC requires further study. The objective of this project was to determine if prostate MP-MRI and PSA can provide complementary insights into CSPC risk stratification. Methods In an IRB-approved study, pathologic outcomes from patients who underwent MR/US fusion-targeted prostate biopsy were stratified by various parameters including PSA, PSA density (PSAD), age, race, and PI-RADS v2 score. CSPC was defined as a Gleason score ≥7. Logistic regression was used to determine odds ratios (OR) with 95% confidence intervals (CI). P values were reported as two-sided with p< 0.05 considered statistically significant. ROC curves were generated for assessing the predictive value of tests and sensitivity + specificity optimization was performed to determine optimal testing cutoffs. Results A total of 327 patients with 709 lesions total were analyzed. PSAD and PI-RADS scores provided complementary predictive...

Purpose of Review To highlight the recent evidence about the use of mp-MRI in the local staging of prostate cancer, enhancing the potential benefits compared to the known and more invasive canonical staging methods. Recent Findings Multiparametric magnetic resonance (mp-MRI) plays a key role not only in diagnosis, but also in local staging of prostate cancer, as it can assess with high accuracy the extracapsular extension of the tumor, invasion of seminal vesicles, the involvement of lymph nodes and the presence of possible bone metastases. Summary Prostate cancer is currently the most common male cancer in Europe and it is associated with a high mortality rate, which is why it is necessary to make an early and accurate diagnosis. Firstly, it is important to distinguish between a disease confined to the gland and a disease with a loco regional or remote extension, since neoplastic staging is the starting point for risk stratification, prognosis and therapeutic planning. According to the PI-RADS guidelines v 2.1 the main mp-MRI sequences necessary to obtain a complete and accurate resonance imaging are the T2-weighted sequences (T2WI), which represent the pivotal morphological sequences for local staging, together with the diffusion-weighted imaging (DWI) and dynamic sequences acquired after intravenous contrast medium administration (DCE). However, due to some limitations, mp-MRI does not have the same diagnostic power in the evaluation of lymph nodes, for which the gold s...

• Review Article • 17 July 2019 Multiparametric MRI for prostate cancer diagnosis: current status and future directions • ORCID: orcid.org/0000-0002-3700-0069 • ORCID: orcid.org/0000-0001-5218-6431 • • • • • • ORCID: orcid.org/0000-0003-4230-0338 • • … • Show authors Nature Reviews Urology volume 17, pages 41–61 ( 2020) The current diagnostic pathway for prostate cancer has resulted in overdiagnosis and consequent overtreatment as well as underdiagnosis and missed diagnoses in many men. Multiparametric MRI (mpMRI) of the prostate has been identified as a test that could mitigate these diagnostic errors. The performance of mpMRI can vary depending on the population being studied, the execution of the MRI itself, the experience of the radiologist, whether additional biomarkers are considered and whether mpMRI-targeted biopsy is carried out alone or in addition to systematic biopsy. A number of challenges to implementation remain, such as ensuring high-quality execution and reporting of mpMRI and ensuring that this diagnostic pathway is cost-effective. Nevertheless, emerging clinical trial data support the adoption of this technology as part of the standard of care for the diagnosis of prostate cancer. • Multiparametric MRI (mpMRI) of the prostate is a novel promising tool for diagnosis of prostate cancer that might help to reduce overdiagnosis of insignificant prostate cancer. • mpMRI should include four sequences: T1-weighted images, T2-weighted images, diffusion-weighted i...