Prostate magnetic resonance imaging: challenges of implementation.

Prostate cancer is among the most common causes of cancer and cancer deaths in men. Screening methods and optimal treatments have become controversial in recent years. Prostate magnetic resonance imaging (MRI) is gaining popularity as a tool to assist diagnosis, risk assessment, and staging. However, implementation into clinical practice can be difficult, with many challenges associated with image acquisition, postprocessing, interpretation, reporting, and radiologic-pathologic correlation. Although state-of-the-art technology is available at select sites for targeting tissue biopsy and interpreting multiparametric prostate MRI, many institutions struggle with adapting this new technology into an efficient multidisciplinary model of patient care. This article reviews several of the challenges that radiologists should be aware of when integrating prostate MRI into their clinical practice.

[1]  Andrew B Rosenkrantz,et al.  Radiologist, be aware: ten pitfalls that confound the interpretation of multiparametric prostate MRI. , 2014, AJR. American journal of roentgenology.

[2]  Jelle O. Barentsz,et al.  Prostate cancer: comparison of local staging accuracy of pelvic phased-array coil alone versus integrated endorectal–pelvic phased-array coils , 2007, European Radiology.

[3]  Yuri Kitamura,et al.  Conventional MRI capabilities in the diagnosis of prostate cancer in the transition zone. , 2006, AJR. American journal of roentgenology.

[4]  P. Carroll,et al.  Carcinoma of the prostate gland: MR imaging with pelvic phased-array coils versus integrated endorectal--pelvic phased-array coils. , 1994, Radiology.

[5]  P. Corso,et al.  National Institutes of Health State-of-the-Science Conference , 2012 .

[6]  T. Gomes,et al.  National Institutes of Health State-of-the-Science Conference: role of active surveillance in the management of men with localized prostate cancer. , 2012 .

[7]  Masoom A Haider,et al.  Combined T2-weighted and diffusion-weighted MRI for localization of prostate cancer. , 2007, AJR. American journal of roentgenology.

[8]  A. Villers Words of wisdom. Re: Improving detection of clinically significant prostate cancer: MRI/TRUS fusion-guided prostate biopsy. , 2014, European urology.

[9]  Diffusionsgewichtete MRT der Prostata , 2011, Der Radiologe.

[10]  P. Choyke,et al.  Prostate cancer: value of multiparametric MR imaging at 3 T for detection--histopathologic correlation. , 2010, Radiology.

[11]  B. Carey,et al.  Magnetic resonance imaging for the detection, localisation, and characterisation of prostate cancer: recommendations from a European consensus meeting. , 2011, European urology.

[12]  M. Sumura,et al.  Usefulness of diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging in the diagnosis of prostate transition-zone cancer , 2008, Acta radiologica.

[13]  H. Hricak,et al.  Value of the hemorrhage exclusion sign on T1-weighted prostate MR images for the detection of prostate cancer. , 2012, Radiology.

[14]  P. Mozer,et al.  Validation of the European Society of Urogenital Radiology scoring system for prostate cancer diagnosis on multiparametric magnetic resonance imaging in a cohort of repeat biopsy patients. , 2012, European urology.

[15]  D. Corle,et al.  Radical prostatectomy versus expectant treatment for early carcinoma of the prostate. Twenty-three year follow-up of a prospective randomized study. , 1995, Scandinavian journal of urology and nephrology. Supplementum.

[16]  C. Pan,et al.  Comparative analysis of sampling methods for grossing radical prostatectomy specimens performed for nonpalpable (stage T1c) prostatic adenocarcinoma. , 2001, Human pathology.

[17]  J. Fütterer,et al.  Value of 3-T Multiparametric Magnetic Resonance Imaging and Magnetic Resonance–Guided Biopsy for Early Risk Restratification in Active Surveillance of Low-Risk Prostate Cancer: A Prospective Multicenter Cohort Study , 2014, Investigative radiology.

[18]  Wei Huang,et al.  Signal-to-noise ratio, contrast-to-noise ratio and pharmacokinetic modeling considerations in dynamic contrast-enhanced magnetic resonance imaging. , 2012, Magnetic resonance imaging.

[19]  Koon Ho Rha,et al.  Tumor lesion diameter on diffusion weighted magnetic resonance imaging could help predict insignificant prostate cancer in patients eligible for active surveillance: preliminary analysis. , 2013, The Journal of urology.

[20]  A. Jemal,et al.  Cancer statistics, 2014 , 2014, CA: a cancer journal for clinicians.

[21]  Thomas Hambrock,et al.  Relationship between apparent diffusion coefficients at 3.0-T MR imaging and Gleason grade in peripheral zone prostate cancer. , 2011, Radiology.

[22]  P. Choyke,et al.  Can magnetic resonance-ultrasound fusion biopsy improve cancer detection in enlarged prostates? , 2013, The Journal of urology.

[23]  K. Kihara,et al.  Usefulness of pre-biopsy multiparametric magnetic resonance imaging and clinical variables to reduce initial prostate biopsy in men with suspected clinically localized prostate cancer. , 2013, The Journal of urology.

[24]  Hans Garmo,et al.  Radical prostatectomy versus watchful waiting in early prostate cancer. , 2005, The New England journal of medicine.

[25]  Peter C Albertsen,et al.  Prostate cancer diagnosis and treatment after the introduction of prostate-specific antigen screening: 1986-2005. , 2009, Journal of the National Cancer Institute.

[26]  Baris Turkbey,et al.  Multiparametric 3T prostate magnetic resonance imaging to detect cancer: histopathological correlation using prostatectomy specimens processed in customized magnetic resonance imaging based molds. , 2011, The Journal of urology.

[27]  C Allen,et al.  Prostate MRI: who, when, and how? Report from a UK consensus meeting. , 2013, Clinical radiology.

[28]  Gaelle Fiard,et al.  Targeted MRI-guided prostate biopsies for the detection of prostate cancer: initial clinical experience with real-time 3-dimensional transrectal ultrasound guidance and magnetic resonance/transrectal ultrasound image fusion. , 2013, Urology.

[29]  H Alberto Vargas,et al.  Diffusion-weighted MRI of the prostate at 3.0 T: comparison of endorectal coil (ERC) MRI and phased-array coil (PAC) MRI-The impact of SNR on ADC measurement. , 2013, European journal of radiology.

[30]  H. Hricak,et al.  Performance characteristics of MR imaging in the evaluation of clinically low-risk prostate cancer: a prospective study. , 2012, Radiology.

[31]  D. Dearnaley,et al.  A study of diffusion-weighted magnetic resonance imaging in men with untreated localised prostate cancer on active surveillance. , 2009, European urology.

[32]  François Cornud,et al.  Multiparametric magnetic resonance imaging for the detection and localization of prostate cancer: combination of T2‐weighted, dynamic contrast‐enhanced and diffusion‐weighted imaging , 2011, BJU international.

[33]  J. Babb,et al.  Comparison of interreader reproducibility of the prostate imaging reporting and data system and likert scales for evaluation of multiparametric prostate MRI. , 2013, AJR. American journal of roentgenology.

[34]  Thomas Hambrock,et al.  Transition zone prostate cancer: detection and localization with 3-T multiparametric MR imaging. , 2013, Radiology.

[35]  Chris Metcalfe,et al.  Short term outcomes of prostate biopsy in men tested for cancer by prostate specific antigen: prospective evaluation within ProtecT study , 2012, BMJ : British Medical Journal.

[36]  Javier Hernandez,et al.  Prostate MRI: access to and current practice of prostate MRI in the United States. , 2014, Journal of the American College of Radiology : JACR.

[37]  C. Kim,et al.  High-b-value diffusion-weighted imaging at 3 T to detect prostate cancer: comparisons between b values of 1,000 and 2,000 s/mm2. , 2010, AJR. American journal of roentgenology.

[38]  J. Fütterer,et al.  ESUR prostate MR guidelines 2012 , 2012, European Radiology.

[39]  B. Hamm,et al.  Evaluation of the Prostate Imaging Reporting and Data System for the Detection of Prostate Cancer by the Results of Targeted Biopsy of the Prostate , 2014, Investigative radiology.

[40]  Baris Turkbey,et al.  Comparison of endorectal coil and nonendorectal coil T2W and diffusion‐weighted MRI at 3 Tesla for localizing prostate cancer: Correlation with whole‐mount histopathology , 2014, Journal of magnetic resonance imaging : JMRI.

[41]  Gary Liney,et al.  Correlation of diffusion‐weighted magnetic resonance data with cellularity in prostate cancer , 2009, BJU international.

[42]  Aytekin Oto,et al.  Apparent diffusion coefficient for prostate cancer imaging: impact of B values. , 2014, AJR. American journal of roentgenology.

[43]  P. Choyke,et al.  Accuracy of multiparametric magnetic resonance imaging in confirming eligibility for active surveillance for men with prostate cancer , 2013, Cancer.

[44]  H. Hricak,et al.  Assessment of biologic aggressiveness of prostate cancer: correlation of MR signal intensity with Gleason grade after radical prostatectomy. , 2008, Radiology.

[45]  J. Babb,et al.  Diffusion‐weighted imaging of the prostate: Comparison of b1000 and b2000 image sets for index lesion detection , 2013, Journal of magnetic resonance imaging : JMRI.

[46]  D. Beyersdorff,et al.  MRI of prostate cancer at 1.5 and 3.0 T: comparison of image quality in tumor detection and staging. , 2005, AJR. American journal of roentgenology.

[47]  Baris Turkbey,et al.  Overview of dynamic contrast-enhanced MRI in prostate cancer diagnosis and management. , 2012, AJR. American journal of roentgenology.

[48]  Deanna L Langer,et al.  Intermixed normal tissue within prostate cancer: effect on MR imaging measurements of apparent diffusion coefficient and T2--sparse versus dense cancers. , 2008, Radiology.

[49]  Wei Huang,et al.  A feasible high spatiotemporal resolution breast DCE-MRI protocol for clinical settings. , 2012, Magnetic resonance imaging.

[50]  Evis Sala,et al.  Transition zone prostate cancers: features, detection, localization, and staging at endorectal MR imaging. , 2006, Radiology.

[51]  Timothy J Wilt,et al.  Radical prostatectomy versus observation for localized prostate cancer. , 2012, The New England journal of medicine.

[52]  T. Wilt,et al.  Screening for prostate cancer. , 2013, The Cochrane database of systematic reviews.

[53]  Y. Yamashita,et al.  Ultra-high-b-value diffusion-weighted MR imaging for the detection of prostate cancer: evaluation in 201 cases with histopathological correlation , 2010, European Radiology.

[54]  Baris Turkbey,et al.  Prostate cancer: can multiparametric MR imaging help identify patients who are candidates for active surveillance? , 2013, Radiology.

[55]  J. Babb,et al.  Prostate cancer localization using multiparametric MR imaging: comparison of Prostate Imaging Reporting and Data System (PI-RADS) and Likert scales. , 2013, Radiology.

[56]  P. Albers,et al.  Inter-reader agreement of the ESUR score for prostate MRI using in-bore MRI-guided biopsies as the reference standard , 2013, European Radiology.

[57]  Takeshi Yoshikawa,et al.  Clinical utility of apparent diffusion coefficient values obtained using high b‐value when diagnosing prostate cancer using 3 tesla MRI: Comparison between ultra‐high b‐value (2000 s/mm2) and standard high b‐value (1000 s/mm2) , 2012, Journal of magnetic resonance imaging : JMRI.

[58]  A. Okuyama,et al.  Characterization of low-intensity lesions in the peripheral zone of prostate on pre-biopsy endorectal coil MR imaging , 2002, European Radiology.

[59]  Baris Turkbey,et al.  Improving detection of clinically significant prostate cancer: magnetic resonance imaging/transrectal ultrasound fusion guided prostate biopsy. , 2014, The Journal of urology.

[60]  A. Evans,et al.  Prostate cancer detection with multi‐parametric MRI: Logistic regression analysis of quantitative T2, diffusion‐weighted imaging, and dynamic contrast‐enhanced MRI , 2009, Journal of magnetic resonance imaging : JMRI.

[61]  Fang-Ming Deng,et al.  Prostate cancer: comparison of dynamic contrast-enhanced MRI techniques for localization of peripheral zone tumor. , 2013, AJR. American journal of roentgenology.

[62]  V. Moyer,et al.  Screening for Prostate Cancer: U.S. Preventive Services Task Force Recommendation Statement , 2012, Annals of Internal Medicine.

[63]  Thomas Hambrock,et al.  Prostate cancer: body-array versus endorectal coil MR imaging at 3 T--comparison of image quality, localization, and staging performance. , 2007, Radiology.

[64]  G. Ligabue,et al.  Comparative Evaluation Between External Phased Array Coil at 3 T and Endorectal Coil at 1.5 T: Preliminary Results , 2006, Journal of computer assisted tomography.

[65]  David Chia,et al.  Mortality results from a randomized prostate-cancer screening trial. , 2009, The New England journal of medicine.

[66]  Aytekin Oto,et al.  Prostate cancer: differentiation of central gland cancer from benign prostatic hyperplasia by using diffusion-weighted and dynamic contrast-enhanced MR imaging. , 2010, Radiology.

[67]  B. K. Park,et al.  Comparison of Phased-Array 3.0-T and Endorectal 1.5-T Magnetic Resonance Imaging in the Evaluation of Local Staging Accuracy for Prostate Cancer , 2007, Journal of computer assisted tomography.

[68]  Thomas Hambrock,et al.  Prostate cancer: multiparametric MR imaging for detection, localization, and staging. , 2011, Radiology.