Multiparametric prostate MR imaging with T2-weighted, diffusion-weighted, and dynamic contrast-enhanced sequences, "Beyond the Abstract," by Oguz Akin, MD

BERKELEY, CA (UroToday.com) - Magnetic resonance (MR) imaging has become the imaging method of choice for the assessment of localized prostate cancer. However, after radiation treatment, conventional MR imaging is of limited use in the detection of recurrent prostate cancer. In a previous preliminary study, we showed that when conventional MRI is combined with functional MR imaging techniques such as diffusion-weighted (DW) MR imaging or dynamic contrast material–enhanced (DCE) MR imaging, recurrent tumor detection within the radiated prostate markedly improved.[1]

Given the promising results obtained by this kind of multi-parametric MR imaging approach, in the current study we aimed to find out which combination of MRI methods would provide optimal detection of tumor recurrence after radiation therapy.[2] Our results showed that while multi-parametric MRI improved the detection of recurrent prostate cancer in men treated with radiation, validating our previous findings, the optimal choice of imaging approach appeared to be the combination of conventional MRI with DW MR imaging. The addition of DCE-MR imaging, which could be associated with risks and costs due to intravenous injection of MRI contrast agent, did not provide significant added value to this approach.

Another important finding from our study was that the addition of DW MR imaging significantly improved the agreement in image interpretation by the two independent study radiologists.

References:

  1. Akin O, Gultekin DH, Vargas HA, Zheng J, Moskowitz C, Pei X, Sperling D, Schwartz LH, Hricak H, Zelefsky MJ. Incremental value of diffusion weighted and dynamic contrast enhanced MRI in the detection of locally recurrent prostate cancer after radiation treatment: preliminary results. Eur Radiol. 2011 Sep;21(9):1970-8.
  2. Donati OF, Jung SI, Vargas HA, Gultekin DH, Zheng J, Moskowitz CS, Hricak H, Zelefsky MJ, Akin O. Multiparametric Prostate MR Imaging with T2-weighted, Diffusion-weighted, and Dynamic Contrast-enhanced Sequences: Are All Pulse Sequences Necessary to Detect Locally Recurrent Prostate Cancer after Radiation Therapy? Radiology. 2013 Aug;268(2):440-50.

 

 

Written by:
Oguz Akin, MD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.

Departments of Radiology, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10065 USA

Multiparametric prostate MR imaging with T2-weighted, diffusion-weighted, and dynamic contrast-enhanced sequences: Are all pulse sequences necessary to detect locally recurrent prostate cancer after radiation therapy? - Abstract

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