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Review
. 2015 Oct;5(5):754-64.
doi: 10.3978/j.issn.2223-4292.2015.10.08.

Current role of multiparametric magnetic resonance imaging for prostate cancer

Romaric Loffroy  1 , Olivier Chevallier  1 , Morgan Moulin  1 , Sylvain Favelier  1 , Pierre-Yves Genson  1 , Pierre Pottecher  1 , Gilles Crehange  1 , Alexandre Cochet  1 , Luc Cormier  1
Affiliations
Review

Current role of multiparametric magnetic resonance imaging for prostate cancer

Romaric Loffroy et al. Quant Imaging Med Surg. 2015 Oct.

Retraction in

Abstract

Multiparametric magnetic resonance imaging (mp-MRI) has shown promising results in diagnosis, localization, risk stratification and staging of clinically significant prostate cancer, and targeting or guiding prostate biopsy. mp-MRI consists of T2-weighted imaging (T2WI) combined with several functional sequences including diffusion-weighted imaging (DWI), perfusion or dynamic contrast-enhanced imaging (DCEI) and spectroscopic imaging. Recently, mp-MRI has been used to assess prostate cancer aggressiveness and to identify anteriorly located tumors before and during active surveillance. Moreover, recent studies have reported that mp-MRI is a reliable imaging modality for detecting local recurrence after radical prostatectomy or external beam radiation therapy. Because assessment on mp-MRI can be subjective, use of the newly developed standardized reporting Prostate Imaging and Reporting Archiving Data System (PI-RADS) scoring system and education of specialist radiologists are essential for accurate interpretation. This review focuses on the current place of mp-MRI in prostate cancer and its evolving role in the management of prostate cancer.

Keywords: Prostate cancer; active surveillance; diffusion imaging; functional imaging; multiparametric-MRI.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
A 66-year-old patient, with PSA of 19.8, Gleason 3+4 on multiple cores, undergoing post-biopsy staging mp-MRI. (A) Axial T2-weighted MRI shows a small posterior mid-peripheral zone hyposignal lesion; (B,C) on multiparametric map of apparent diffusion coefficient (ADC) from axial diffusion-weighted MRI, prostate cancer shows significantly decreased values; (D,E) axial dynamic contrast-enhanced imaging (DCEI) shows early enhancement in the posterior mid-peripheral zone; (F) typical post-contrast wash-in/wash-out curve of the tumor lesion. PSA, prostate-specific antigen; mp-MRI, multiparametric magnetic resonance imaging.
Figure 2
Figure 2
A 55-year-old patient with a PSA of 12.3, previously diagnosed with Gleason 3+3 cancer on 12-core template biopsy. (A) Axial T2-weighted image shows a large hypointense signal in right apical peripheral zone with capsular bulge; (B) apparent diffusion coefficient (ADC) map from axial diffusion-weighted imaging (DWI) showing hypointense signal and restricted diffusion of the lesion; (C,D) axial dynamic contrast-enhanced imaging (DCEI) showing strong early enhancement in the right apical peripheral zone; (E) typical post-contrast wash-in/wash-out curve of the tumor lesion. PSA, prostate-specific antigen.
Figure 3
Figure 3
Multiparametric magnetic resonance imaging (mp-MRI) detects significant prostate cancer. This 63-year-old man had a doubling of serum PSA in less than 2 years. (A) A pseudonodular mass of the anterolateral part of the left mid-peripheral prostate with low signal on T2-weighted imaging (T2WI) is shown; (B) this mass is associated with low signal on the apparent diffusion coefficient (ADC) map signifying restricted diffusion; (C) focal asymmetric early enhancement on the arterial phase of the dynamic contrast-enhanced perfusion imaging. Targeted biopsies of this area revealed high volume Gleason 4+3=7 cancer. PSA, prostate-specific antigen.
Figure 4
Figure 4
Typical graphics obtained from magnetic resonance spectroscopic imaging (MRSI). (A) Multivoxel spectroscopic imaging on the prostate; (B) normal prostatic tissue: (Ch + Cr)/Ci <0.5; (C) prostate cancer: (Ch + Cr)/Ci >0.8.
See this image and copyright information in PMC

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