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Round table: arguments against using multiparametric prostate MRI protocols

  • Special Section: Prostate cancer update
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Abstract

Biparametric MRI (bpMRI), which uses only T2-weighted imaging and diffusion-weighted imaging, continues to gain support for the detection of prostate cancer, as this imaging technique offers many benefits over traditional mpMRI. However, the Prostate Imaging Reporting and Data System (PI-RADS) v2.1 document released in 2019 emphasized that mpMRI is still preferred over bpMRI in most clinical scenarios. As one article in a series of four providing arguments for and against using mpMRI and bpMRI protocols, this paper provides arguments against using mpMRI. Within this article, we discuss recent data suggesting equivalent performance between bpMRI and mpMRI in the detection of prostate cancer. The limited utility of dynamic contrast enhancement in the evaluation of prostate cancer according to the PI-RADS v2.1 document is also reviewed. Finally, we detail the large financial and time costs, legal and logistical issues, and potential for patient harm that must be considered with the administration of contrast.

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Acknowledgements

We are grateful for the editorial assistance of Megan M. Griffiths, scientific writer for the Imaging Institute, Cleveland Clinic, Cleveland, OH.

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Authors and Affiliations

  1. Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, USA

    Ryan Ward

  2. Section of Abdominal Imaging and Nuclear Radiology Department, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Mail Code JB-322, Cleveland, OH, 44145, USA

    Andrei S. Purysko

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Correspondence to Andrei S. Purysko.

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Andrei S. Purysko: research support from Invivo Corp, Radiological Society of North America R&E Foundation; service contract with Profound Medical. Other authors report no conflicts of interest.

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Ward, R., Purysko, A.S. Round table: arguments against using multiparametric prostate MRI protocols. Abdom Radiol 45, 3997–4002 (2020). https://doi.org/10.1007/s00261-020-02456-z

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