Impact of dynamic contrast-enhanced MRI in 1.5 T versus 3 T MRI for clinically significant prostate cancer detection.

This study analyzes the value of dynamic contrast-enhanced MRI (DCE) of the prostate on 1.5 T and 3 T examinations in patients within PI-RADS category 4.

In this retrospective, bi-centric, cohort study all consecutive patients classified as PI-RADS 4 in mpMRI with 100 verified prostate cancers (PCa) in subsequent MRI/US-guided fusion biopsy were included for 1. 5 T and 3 T, each. PCa detection in index lesions (IL) upgraded to PI-RADS 4 based on positive DCE findings was compared between 1.5 T and 3 T. Secondary objectives are subgroup analysis of PZ lesions and comparison of ISUP grade group distribution between 1.5 T and 3 T.

In total, 293 patients within PI-RADS category 4, including 152 (mean 66 ± 8y; median PSA 6.4 ng/ml;116 PZ IL) in the 1.5 T group and 141 (mean 65 ± 8y; median PSA 7.2 ng/ml;100 PZ IL) in the 3 T group were included. Overall amount of PCa (66 % vs 71 %; p = 0.346) and portion of upgraded IL (28 % vs 21 %; p = 0.126) did not differ significantly. At 1.5 T PCa detection was higher in upgraded PZ lesions compared to 3 T (33 % vs 19 %; p = 0.048). The amount of upgraded PZ lesions with ISUP grade group 2-5 PCa was significantly higher at 1.5 T versus 3 T (32 % vs 9 %; p = 0.007). 33 % (11/33; 1.5 T) and 32 % (10/31; 3 T) of the ISUP grade group 1 PCa were detected in upgraded PZ lesions (13 % of the detected PCa in PZ lesions, respectively).

DCE enabled the detection of a substantial amount of additional clinically significant PCa in prostate mpMRI at 1.5 T. The effect was smaller at 3 T and was accompanied in relation to 1.5 T by higher risk of overdiagnosis due to detection of additional low-risk PCa.

European journal of radiology. 2022 Sep 13 [Epub ahead of print]

F Ziayee, L Schimmöller, D Blondin, M Boschheidgen, L M Wilms, M Vach, C Arsov, P Albers, G Antoch, T Ullrich

University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany. Electronic address: ., Community Hospital Moenchengladbach GmbH, Elisabeth-Hospital Rheydt, Department of Radiology, Vascular Radiology, and Nuclear Medicine, D-41239 Moenchengladbach, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Urology, D-40225 Dusseldorf, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany. Electronic address: ., University Dusseldorf, Medical Faculty, Department of Diagnostic and Interventional Radiology, D-40225 Dusseldorf, Germany. Electronic address: .

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