SAN DIEGO, CA USA (UroToday.com) - Endorectal MRI presents a useful adjunct for prostate cancer diagnosis and staging. Dr. Peter Choyke presented an update on recent improvements in MRI and MR spectroscopy.
Although the adjunctive use of an endorectal coil provides an increased signal-to-noise ratio and improved resolution, it is costly, can cause significant patient discomfort, and increases the time needed for study completion.
The use of 3T non-coil 32-channel imaging has achieved good results, comparable to the use of an endorectal coil.
T2 imaging remains adequate, without the use of a coil, but diffusion-weighted images have decreased resolution.
Improvements in diffusion-weighted imaging (DWI) represent the most exciting advances in prostate MRI imaging. By increasing the “b” values, scans may be able to help discriminate BPH from cancer. Dynamic contrast-enhanced MRI can be improved by motion correction, shorter scanning sequences, and the use of Gadofosveset (albumin-bound contrast).
Finally, hyperpolarized Carbon 13 pyruvate is a promising imaging adjunct. Pyruvate is converted to lactate in the presence of cancer and may provide a window into tumor metabolism. Computer-aided diagnosis-probability maps based on multiple parameters require quantitative MRI but can help dial in sensitivity/specificity tradeoffs.
Presented by Peter Choyke, MD at the Society of Urologic Oncology (SUO) meeting preceding the American Urological Association (AUA) Annual Meeting - May 4 - 8, 2013 - San Diego Convention Center - San Diego, California USA
Head, Imaging Section, Program Director, Center for Cancer Research, National Cancer Institute, Bethesda, MD USA
Reported for UroToday.com by Jeffrey Tomaszewski, MD