Dynamic Contrast-Enhanced Study in the mpMRI of the Prostate—Unnecessary or Underutilised? A Narrative Review

Abstract

The aim of this review is to summarise recent scientific literature regarding the clinical use of DCE-MRI as a component of multiparametric resonance imaging of the prostate. This review presents the principles of DCE-MRI acquisition and analysis, the current role of DCE-MRI in clinical practice with special regard to its role in presently available categorisation systems, and an overview of the advantages and disadvantages of DCE-MRI described in the current literature. DCE-MRI is an important functional sequence that requires intravenous administration of a gadolinium-based contrast agent and gives information regarding the vascularity and capillary permeability of the lesion. Although numerous studies have confirmed that DCE-MRI has great potential in the diagnosis and monitoring of prostate cancer, its role is still inadequate in the PI-RADS categorisation. Moreover, there have been numerous scientific discussions about abandoning the intravenous application of gadolinium-based contrast as a routine part of MRI examination of the prostate. In this review, we summarised the recent literature on the advantages and disadvantages of DCE-MRI, focusing on an overview of currently available data on bpMRI and mpMRI, as well as on studies providing information on the potential better usability of DCE-MRI in improving the sensitivity and specificity of mpMRI examinations of the prostate.

Comparison of Early Contrast Enhancement Models in Ultrafast Dynamic Contrast-Enhanced Magnetic Resonance Imaging of Prostate Cancer

“…The limited contribution that DCE-MRI makes to PCa diagnosis in the majority of cases under PI-RADS guidelines has led many to question whether the additional costs (contrast agent, preparation, scan, and reporting time) are warranted [28][29][30][31]. Unfortunately, this small pilot study is not sufficient to provide indications for use in problematic areas such as differentiating benign hyperplasia from carcinoma in the transitional zone or prostatitis from carcinoma in the peripheral zone [32].…”