The necessity of dynamic contrast enhanced imaging for prostate MRI: A study of pathologic outcomes on prostate biopsy.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 52-52
Author(s):  
Sasha C. Druskin ◽  
Jeffrey J. Tosoian ◽  
Allen Young ◽  
Kamyar Ghabili ◽  
Darian Andreas ◽  
...  
Keyword(s):  
Prostate Biopsy ◽  
Peripheral Zone ◽  
Intravenous Contrast ◽  
Grade Group ◽  
Prostate Mri ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
The Difference ◽  
Clinically Significant ◽  
The Cost

52 Background: PIRADS version 2 guidelines for the interpretation of multi-parametric prostate MRI (mpMRI) stipulates that dynamic contrast-enhanced (DCE) imaging be used to classify diffusion weighted imaging (DWI) score 3 peripheral zone lesions into PIRADS-3 (DCE-) or PIRADS-4 (DCE+) lesions. Despite this, it is unknown if DCE based classification separates lesions into clinically meaningful pathologic groups. Because use of contrast adds time, risk (though modest), and cost to mpMRI, we sought to examine whether use of DCE indeed improves detection of clinically-significant cancer. Methods: Using the Johns Hopkins MRI-ultrasound fusion prostate biopsy database and including only patients without a prior diagnosis of prostate cancer (n = 232), we identified patients with peripheral zone DWI-3 or DWI-4 lesions who underwent targeted biopsy of those lesions. Each lesion meeting the MRI criteria was considered separately, and grouped into one of three lesion MRI classifications – DWI-3/DCE-/PIRADS-3, DWI-3/DCE+/PIRADS-4, or DWI-4/PIRADS-4. The rates of benign, grade group (GG) 1, and GG ≥ 2 pathology were compared between the MRI classification groups. Results: One hundred forty-eight peripheral zone DWI-3 or DWI-4 lesions from a total of 106 patients were identified. The rate of benign(%)/GG1(%)/GG ≥ 2(%) biopsy pathology in the groups DWI-3/DCE-/PIRADS-3 (61 lesions), DWI-3/DCE+/PIRADS-4 (37 lesion), and DWI-4/PIRADS-4 (47 lesions) was 68.9/18.0/8.2, 59.5/13.5/18.9, and 44.7/23.4/27.7, respectively (P > 0.05 for the difference in rates of GG ≥ 2 pathology between the two PIRADS-4 groups and the two DWI-3 groups). Conclusions: Given the cost and morbidity of using intravenous contrast agents in prostate MRI, their clinical utility must be determined. In this study, DWI-3 peripheral zone lesions with DCE positivity appear to have a higher rate of clinically-significant (GG ≥ 2) cancer on biopsy. This study supports the use of DCE to better classify DWI-3 peripheral zone lesions however further study with expanded cohorts is indicated.

scholarly journals Understanding PI-QUAL for prostate MRI quality: a practical primer for radiologists

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Francesco Giganti ◽  
Alex Kirkham ◽  
Veeru Kasivisvanathan ◽  
Marianthi-Vasiliki Papoutsaki ◽  
Shonit Punwani ◽  
...  
Keyword(s):  
Diffusion Weighted Imaging ◽  
Signal To Noise Ratio ◽  
High Signal ◽  
Diagnostic Quality ◽  
Prostate Mri ◽  
Prostate Imaging ◽  
Dynamic Contrast Enhanced ◽  
Diffusion Weighted ◽  
Contrast Enhanced

AbstractProstate magnetic resonance imaging (MRI) of high diagnostic quality is a key determinant for either detection or exclusion of prostate cancer. Adequate high spatial resolution on T2-weighted imaging, good diffusion-weighted imaging and dynamic contrast-enhanced sequences of high signal-to-noise ratio are the prerequisite for a high-quality MRI study of the prostate. The Prostate Imaging Quality (PI-QUAL) score was created to assess the diagnostic quality of a scan against a set of objective criteria as per Prostate Imaging-Reporting and Data System recommendations, together with criteria obtained from the image. The PI-QUAL score is a 1-to-5 scale where a score of 1 indicates that all MR sequences (T2-weighted imaging, diffusion-weighted imaging and dynamic contrast-enhanced sequences) are below the minimum standard of diagnostic quality, a score of 3 means that the scan is of sufficient diagnostic quality, and a score of 5 implies that all three sequences are of optimal diagnostic quality. The purpose of this educational review is to provide a practical guide to assess the quality of prostate MRI using PI-QUAL and to familiarise the radiologist and all those involved in prostate MRI with this scoring system. A variety of images are also presented to demonstrate the difference between suboptimal and good prostate MR scans.

Prostate Cancer: Comparison of Dynamic Contrast-Enhanced MRI Techniques for Localization of Peripheral Zone Tumor

2013 ◽  
Vol 201 (3) ◽  
pp. W471-W478 ◽  
Author(s):  
Andrew B. Rosenkrantz ◽  
Amy Sabach ◽  
James S. Babb ◽  
Brent W. Matza ◽  
Samir S. Taneja ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Peripheral Zone ◽  
Dynamic Contrast Enhanced Mri ◽  
Dynamic Contrast Enhanced ◽  
Enhanced Mri ◽  
Contrast Enhanced ◽  
Contrast Enhanced Mri

scholarly journals Evaluation of chronic headache by computed tomography: a retrospective study

2012 ◽  
Vol 1 (2) ◽  
pp. 64-71 ◽  
Author(s):  
Anish Subedee
Keyword(s):  
Computed Tomography ◽  
Chronic Headache ◽  
Patient Management ◽  
Alter Patient ◽  
Contrast Enhanced Ct ◽  
Contrast Enhanced ◽  
Enhanced Ct ◽  
Minor Abnormality ◽  
The Difference ◽  
Clinically Significant

Objective: To find out the proportion of intracranial abnormalities in patients with chronic headache without neurologic abnormality with the use of computed tomography (CT) and to compare the results with similar studies done previously. Materials and methods: CT images of 56 patients with chronic/recurrent headache and normal neurological findings were reviewed retrospectively. In 38 of 56 patients, both plain and contrast enhanced CT were done. Patients were divided into three groups according to the CT findings: those with no abnormality, those with minor abnormality (that did not alter patient management) and those with clinically significant abnormality. Proportion of patients in each group was found out and results were compared with previous studies with similar study design. Z test was used to evaluate whether the difference in proportions of patients in our study and previous study was statistically significant or not. Results: Of the 56 patients, 50 had normal CT (89.28 %), four had minor abnormality (7.14%) that did not alter patient management and two had significant lesions (3.57%). Contrast enhanced CT did not improve lesion detection. The minor findings detected were sub-ependymal calcifications of Tuberous sclerosis, calcified neurocysticercosis and old lacunar infarctions in external capsule. Clinically significant lesions detected were small ring enhancing lesion (neurocysticercosis or tuberculoma) and pineal cyst. Results of this study were compared with previous study with similar study design. The Z test showed that the difference in proportions in these studies was not statistically significant (p =0.0708 for minor findings and p =0.2033 for significant findings). Conclusion: The proportion of intracranial abnormalities detected by CT in this study was similar to that of previous studies. The use of intravenous contrast material administration did not improve its yield. This corroborates the evidence that the ability of CT scan in detecting significant intracranial pathology is poor in patients with chronic headache without neurologic abnormality.DOI: http://dx.doi.org/10.3126/jonmc.v1i2.7301 Journal of Nobel Medical College (2012), Vol.1 No.2 p.57-63

Computerized analysis of prostate lesions in the peripheral zone using dynamic contrast enhanced MRI

2008 ◽  
Vol 35 (3) ◽  
pp. 888-899 ◽  
Author(s):  
Pieter C. Vos ◽  
Thomas Hambrock ◽  
Christina A. Hulsbergen - van de Kaa ◽  
Jurgen J. Fütterer ◽  
Jelle O. Barentsz ◽  
...  
Keyword(s):  
Peripheral Zone ◽  
Dynamic Contrast Enhanced Mri ◽  
Dynamic Contrast Enhanced ◽  
Computerized Analysis ◽  
Enhanced Mri ◽  
Contrast Enhanced ◽  
Contrast Enhanced Mri

scholarly journals Comparison of clinical value of dynamic contrast-enhanced MRI and SPECT renal dynamic imaging of GFR measurement in the evaluation of renal function in renal transplantation

2019 ◽  
Vol 6 (2) ◽  
pp. 7
Author(s):  
Hong G ◽  
Dan L ◽  
Yunhe L
Keyword(s):  
Renal Function ◽  
Renal Transplantation ◽  
Confidence Interval ◽  
Dynamic Imaging ◽  
Clinical Value ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
The Difference ◽  
Contrast Enhanced Mri

Objective: To compare the clinical value of dynamic contrast-enhanced MRI (DCE-MRI) and single-photon emission computed tomography (SPECT) renal dynamic imaging in the measurement of glomerular filtration rate (GFR) in the evaluation of renal function in renal transplantation.Methods: A total of 70 recipients who underwent renal transplantation in Baogang Hospital of Inner Mongolia from April of 2015 to April of 2018 were selected as research objects. GFR was measured in renal transplant recipients by use of DCE-MRI and SPECT (GFR-MRI and GFR-SPECT respectively), and was compared with creatinine clearance rate (Ccr). The safety of contrast media was evaluated in DCE-MRI detection.Results: The bias of GFR-MRI against Ccr value was higher than that of GFR-SPECT against Ccr value, with 30% and 50% accuracy of GFR-MRI higher than that of GFR-SPECT, and the difference was statistically significant (p < .05). Pearson correlation analysis showed that GFR-MRI and GFR-SPECT values were positively correlated to Ccr (p < .05), and the correlation coefficient of GFR-MRI and Ccr was higher than that of GFR-SPECT and Ccr, with the difference statistically significant (p < .05). By Bland-Altman analysis, 95% confidence interval of GFR-SPECT was 95.49 ml/(min·1.73 m2), and 95% confidence interval of GFR-MRI was 62.35 ml/(min·1.73m2), which was much narrower. Only 2 cases of patients developed mild rash among 70 cases of patients, and recovered spontaneously without any treatment.Conclusions: Compared with SPECT, the bias of GFR measured by DCE-MRI against Ccr is much greater. However, DCE-MRI has a higher accuracy, correlation and consistency in comparison with Ccr, and it has a narrower confidence interval. DCE-MRI can more accurately evaluate renal function in renal transplantation by measuring GFR, and it has a high safety.

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