The groundswell of interest in mpMRI promises to change this in the near future.
Although prostate mpMRI has been shown to perform well in different clinical scenarios, it has yet to be standardized clinically due to the need for additional scientific evidence on such matters the characteristics and characterization of lesions that are not detected by mpMRI, racial differences in mpMRI outcomes, and optimal time to use mpMRI for the diagnosis of prostate cancer.
In Austria we recognize a growing urological demand for mpMRI of the prostate especially in patients with negative systematic prebiopsies but ongoing tumor suspicion.
Multiparametric magnetic resonance imaging (mpMRI) of the prostate has excellent sensitivity in detecting clinically significant prostate cancer (csPCa).
A systematic approach to mpMRI of the prostate using PI-RADS v. 2 helps in the identification of PCa, but there still remains a wide spectrum of pitfalls.
From October 2011 to May 2013, 143 consecutive patients with a history of at least one negative systematic prebiopsy, who underwent 3 Tesla mpMRI of the prostate because of ongoing tumor suspicion, were included in this retrospective single-center study in Innsbruck.
Our decision analysis suggests that mpMRI of the prostate followed by MRI-targeted biopsy if positive could result in fewer and better biopsies than a strategy using only TRUS-guided biopsy.
The mpMRI datasets were analyzed by two experienced uroradiologists with at least 6 years of experience in prostate MRI interpretation, who compared two different approaches to generate an overall PI-RADS score.
The role of mpMRI in early detection of clinically significant PC is highlighted.
However, the standardization and validation of mpMRI, including quality assurance in acquisition, reading, and reporting, operator skill and experience in drawing ROIs under a grey scale and performing the biopsy along with the non-negligible rate of false negative, leave room to identify other imaging strategies.
