TY - JOUR
T1 - Multiparametric magnetic resonance imaging in prostate cancer
T2 - Present and future
AU - Kurhanewicz, John
AU - Vigneron, Daniel
AU - Carroll, Peter
AU - Coakley, Fergus
PY - 2008/1
Y1 - 2008/1
N2 - PURPOSE OF REVIEW: The purpose of this article is to review the current status of advanced MRI techniques based on anatomic, metabolic and physiologic properties of prostate cancer with a focus on their impact in managing prostate cancer patients. RECENT FINDINGS: Prostate cancer can be identified based on reduced T2 signal intensity on MRI, increased choline and decreased citrate and polyamines on magnetic resonance spectroscopic imaging (MRSI), decreased diffusivity on diffusion tensor imaging (DTI), and increased uptake on dynamic contrast enhanced (DCE) imaging. All can be obtained within a 60-min 3T magnetic resonance exam. Each complementary method has inherent advantages and disadvantages: T2 MRI has high sensitivity but poor specificity; magnetic resonance spectroscopic imaging has high specificity but poor sensitivity; diffusion tensor imaging has high spatial resolution, is the fastest, but sensitivity/specificity needs to be established; dynamic contrast enhanced imaging has high spatial resolution, but requires a gadolinium based contrast agent injection, and sensitivity/specificity needs to be established. SUMMARY: The best characterization of prostate cancer in individual patients will most likely result from a multiparametric (MRI/MRSI/DTI/DCE) exam using 3T magnetic resonance scanners but questions remain as to how to analyze and display this large amount of imaging data, and how to optimally combine the data for the most accurate assessment of prostate cancer. Histological correlations or clinical outcomes are required to determine sensitivity/specificity for each method and optimal combinations of these approaches.
AB - PURPOSE OF REVIEW: The purpose of this article is to review the current status of advanced MRI techniques based on anatomic, metabolic and physiologic properties of prostate cancer with a focus on their impact in managing prostate cancer patients. RECENT FINDINGS: Prostate cancer can be identified based on reduced T2 signal intensity on MRI, increased choline and decreased citrate and polyamines on magnetic resonance spectroscopic imaging (MRSI), decreased diffusivity on diffusion tensor imaging (DTI), and increased uptake on dynamic contrast enhanced (DCE) imaging. All can be obtained within a 60-min 3T magnetic resonance exam. Each complementary method has inherent advantages and disadvantages: T2 MRI has high sensitivity but poor specificity; magnetic resonance spectroscopic imaging has high specificity but poor sensitivity; diffusion tensor imaging has high spatial resolution, is the fastest, but sensitivity/specificity needs to be established; dynamic contrast enhanced imaging has high spatial resolution, but requires a gadolinium based contrast agent injection, and sensitivity/specificity needs to be established. SUMMARY: The best characterization of prostate cancer in individual patients will most likely result from a multiparametric (MRI/MRSI/DTI/DCE) exam using 3T magnetic resonance scanners but questions remain as to how to analyze and display this large amount of imaging data, and how to optimally combine the data for the most accurate assessment of prostate cancer. Histological correlations or clinical outcomes are required to determine sensitivity/specificity for each method and optimal combinations of these approaches.
KW - Diffusion tensor imaging
KW - Dynamic contrast imaging
KW - Magnetic resonance imaging
KW - Magnetic resonance spectroscopic imaging
KW - Prostate cancer
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U2 - 10.1097/MOU.0b013e3282f19d01
DO - 10.1097/MOU.0b013e3282f19d01
M3 - Review article
C2 - 18090494
AN - SCOPUS:37349094329
SN - 0963-0643
VL - 18
SP - 71
EP - 77
JO - Current Opinion in Urology
JF - Current Opinion in Urology
IS - 1
ER -