Abbreviated Prostatic MRI

Kuhl et published in Radiology findings of their study in which they explored the accuracy of an abbreviated MRI of the prostate.  Multi-parametric contrast-enhanced MR imaging was performed in men with elevated PSA who after negative transrectal US-guided biopsy underwent state-of-the-art, full multiparametric contrast-enhanced MR imaging at 3.0-T that included high-spatial-resolution structural imaging in several planes, diffusion-weighted imaging at 0, 800, 1000, and 1400 mm²/sec, and dynamic contrast-enhanced MR imaging, obtained without endorectal coil within 34 minutes 19 seconds.

One of four radiologists first reviewed only two sequences of the study

 consisting of single-plane (axial) structural imaging (T2-weighted turbo spin-echo and diffusion-weighted imaging), acquired within 8 minutes 45 seconds (referred to as bi-parametric MR imaging), and established a diagnosis; only thereafter, the remaining full multiparametric contrast-enhanced MR images were read. Men with PI-RADS categories 3–5 underwent MR-guided targeted biopsy. Men with PI-RADS categories 1–2 remained in urologic follow-up for at least 2 years, with rebiopsy (transrectal US-guided or transperineal) when appropriate. 

A total of 542 men, aged 65 years with median PSA of 7 ng/mL, were included. Bi-parametric MR imaging helped detect clinically significant prostate cancer in 138 men. Full multi-parametric contrast-enhanced MR imaging allowed detection of one additional clinically significant prostate cancer (a stage pT2a, intermediate-risk cancer with a Gleason score of 3+4) and caused 11 additional false-positive diagnoses. Diagnostic accuracy for detection of clinically significant cancer of bi-parametric MR imaging was 89.1% (483 of 542) was similar to that of full multi-parametric contrast-enhanced MR imaging 87.2% (473 of 542). 

The authors concluded that bi-parametric MR imaging which can be done with two sequences and without contrast injection in less that 9 minutes allows for detection of clinically significant prostate cancer with a rate equivalent to conventional full multi-parametric contrast-enhanced MR imaging protocols.