Prostate MRI: Can we do without DCE sequences in 2013?

AbstractMultiparametric MRI (mp-MRI) of the prostate currently provides stable and reproducible performances. The usefulness of dynamic contrast-enhanced (DCE) sequences is currently challenged, as they sometimes only confirm what has already been observed on diffusion-weighted imaging (DWI) and require the additional purchase of a contrast agent. Eliminating these sequences may help accelerate the use of MRI in addition to, or in lieu of, prostate biopsies in selected patients. However, many studies show that these sequences can detect lesions invisible on T2-weighted and diffusion-weighted images, better assess cancer extension and aggressiveness, and finally help detecting recurrence after treatment. We present the various applications of dynamic MRI and discuss the possible consequences of its omission from the current protocol

Detecting prostate cancer with MRI — why and how

AbstractMultiparametric MRI of the prostate is an essential examination for the diagnosis, preoperative evaluation and planning of treatment for prostate cancer. This examination can accurately detect cancer foci in the gland so that the most appropriate management can be offered, reduce the risk of over-treatment and also ensure that certain aggressive lesions or unusual locations, which might affect the prognosis, are not ignored. We present here its main indications, focusing on the techniques for interpreting MRI, its performance and its limitations, as well as the recent European recommendations underlining the need for international harmonisation