mpMRI of the Prostate (MR-Prostatography): Updated Recommendations of the DRG and BDR on Patient Preparation and Scanning Protocol

Franiel, Tobias; Asbach, Patrick; Beyersdorff, Dirk; Blondin, D.; Kaufmann, Sascha; Mueller‐Lisse, Ullrich G.; Quentin, Michael; Rödel, Stefan; Röthke, Matthias; Schimmöller, Lars

doi:10.1055/a-1406-8477

Cited by 11 publications

(2 citation statements)

References 68 publications

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“…All mpMRI scans were conducted on 3 T MRI scanners (Magnetom Prisma; Siemens Healthineers, Forchheim, Germany) using a 60-channel phased-array surface coil. MRI parameters were chosen according to international recommendations and contained T2-weighted turbo spin echo (TSE) sequences in 3 planes (T2WI), diffusion-weighted imaging (DWI) 18 (Supp. Table 1 ).…”

Section: Methodsmentioning

confidence: 99%

Value of magnetic resonance angiography before prostatic artery embolization for intervention planning

Boschheidgen,

Ullrich,

Al-Monajjed

et al. 2024

Sci Rep

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Knowledge about anatomical details seems to facilitate the procedure and planning of prostatic artery embolization (PAE) in patients with symptomatic benign prostatic hyperplasia (BPS). The aim of our study was the pre-interventional visualization of the prostatic artery (PA) with MRA and the correlation of iliac elongation and bifurcation angles with technical success of PAE and technical parameters. MRA data of patients with PAE were analysed retrospectively regarding PA visibility, PA type, vessel elongation, and defined angles were correlated with intervention time, fluoroscopy time, dose area product (DAP), cumulative air kerma (CAK), contrast media (CM) dose and technical success of embolization. T-test, ANOVA, Pearson correlation, and Kruskal–Wallis test was applied for statistical analysis. Between April 2018 and March 2021, a total of 78 patients were included. MRA identified the PA origin in 126 of 147 cases (accuracy 86%). Vessel elongation affected time for catheterization of right PA (p = 0.02), fluoroscopy time (p = 0.05), and CM dose (p = 0.02) significantly. Moderate correlation was observed for iliac bifurcation angles with DAP (r = 0.30 left; r = 0.34 right; p = 0.01) and CAK (r = 0.32 left; r = 0.36 right; p = 0.01) on both sides. Comparing the first half and second half of patients, median intervention time (125 vs. 105 min.) and number of iliac CBCT could be reduced (p < 0.001). We conclude that MRA could depict exact pelvic artery configuration, identify PA origin, and might obviate iliac CBCT. Vessel elongation of pelvic arteries increased intervention time and contrast media dose while the PA origin had no significant influence on intervention time and/or technical success.

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Section: Methodsmentioning

confidence: 99%

Value of magnetic resonance angiography before prostatic artery embolization for intervention planning

Boschheidgen,

Ullrich,

Al-Monajjed

et al. 2024

Sci Rep

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“…Other contexts in which MRI is recommended include tumour staging, follow-up monitoring during active surveillance, investigation for abscess or prostatitis, and assessment of the gland for local recurrence following cancer-treatments [1][2][3][4] . MRI is recommended to be performed with DCE, which will typically require 30-40 minutes appointment slots and will produce ~1,500 images 8,48,49 . Biparametric MRI, in which the study is performed without contrast, is only recommended by PI-RADS under specific circumstances such as patients with low-risk disease undergoing surveillance, and in instances in which quality can be assured and safety checks are in place 50 .…”

Section: [H1] Components Of the Prostate Cancer Diagnostic Pathwaymentioning

confidence: 99%

Quality checkpoints in the MRI-directed prostate cancer diagnostic pathway

et al. 2022

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Multiparametric magnetic resonance imaging (MRI) of the prostate is now recommended as the initial diagnostic test for men presenting with suspected prostate cancer, with a negative MRI enabling safe avoidance of biopsy and a positive result enabling MRI-directed sampling of lesions. The diagnostic pathway consists of several steps, from initial patient presentation and preparation to performing and interpreting MR images, communicating the imaging findings, outlining the prostate and intra-prostatic target lesions, performing the biopsy, and assessing the cores. Each component of this pathway requires experienced clinicians, optimised equipment, good inter-disciplinary communication between specialists, and standardised workflows in order to achieve the expected outcomes. Assessment of quality and mitigation measures are essential for the success of the MRI-directed prostate cancer diagnostic pathway. Quality assurance processes including Prostate Imaging-Reporting and Data System (PI-RADS), template biopsy, and pathology guidelines help minimise variation and ensure optimisation of the diagnostic pathway. Quality control systems including the Prostate Imaging Quality (PI-QUAL) scoring system, patient-level outcomes (such as PI-RADS MRI score assignment and cancer detection rates), multidisciplinary meeting review and audits might also be used to provide consistency of outcomes and ensure that all the benefits of the MRI-directed pathway are achieved. Key points-Multiparametric magnetic resonance imaging (MRI) is now recommended as the initial diagnostic test for men presenting with suspected prostate cancer -A negative MRI enables patients to safely avoid biopsy, whereas a positive MRI prompts targeted biopsy and pathologically accurate tissue sampling.-The MRI-directed prostate cancer diagnostic pathway involves several steps including acquiring and interpreting MR images, communicating MRI findings, outlining suspicious target lesions, performing biopsy, and evaluating the cores.-All steps in the pathway are prone to variation; assessment and mitigation of poor quality and variance are essential for a successful delivery of the MRI-directed pathway -Quality assurance systems to minimise variation in performance and prevent poor quality include Prostate Imaging-Reporting and Data System (PI-RADS) imaging guidelines for radiologists, prostate biopsy templates, and International Society of Urological Pathology (ISUP) guidelines for histopathologists.-Quality control measures include checking MRI compliance with PI-RADS, image quality assessment with the Prostate Imaging Quality (PI-QUAL) scoring system, radiologist certification, multidisciplinary team meeting ( MDT) review and pathology re-review of images, and audits of cancer detection rates and biopsy core quality.

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