High prevalence of prostate cancer with multifocality and biological heterogeneity. Insufficient conventional urological diagnostics. Discrimination between significant and insignificant cancer needed.
Digital rectal examination, prostate-specific antigen (PSA) serum level, systematic transrectal ultrasound (TRUS)-guided prostate biopsy.
Multiparametric magnetic resonance imaging (mpMRI) including T2-weighted (T2w), diffusion-weighted and dynamic contrast-enhanced MRI according to the prostate imaging reporting and data system (PIRADS), MR-targeted biopsy, most frequently MR/TRUS image fusion biopsy.
Prostate cancer is characterized by low signal intensity on T2w MRI, restricted water diffusion and pronounced and early uptake of contrast enhancement. Sensitivity and specificity according to the current literature are ca. 80% and 90%, respectively.
In cases of suspected prostate cancer, most accurate are mpMRI according to PIRADS and in cases of positive findings, MRI-targeted biopsy, most frequently as MRI/TRUS image fusion biopsy.
Der Radiologe. 2017 Jun 30 [Epub ahead of print]
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