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Current Urology Reports

, Volume 13, Issue 1, pp 82–92 | Cite as

Value of Multiparametric MRI in the Work-up of Prostate Cancer

  • F. CornudEmail author
  • N. B. Delongchamps
  • P. Mozer
  • F. Beuvon
  • A. Schull
  • N. Muradyan
  • M. Peyromaure
New Techniques: Imaging (A Atala, Section Editor)

Abstract

The role of magnetic resonance imaging (MRI) in prostate cancer evaluation is controversial and likely underestimated. Technological advances over the past 5 years have demonstrated that multiparametric MRI, including diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI, can evaluate the actual tumor burden of a newly diagnosed prostate cancer more accurately than sextant biopsy protocols. Tumor risk, defined by the D’Amico criteria, hence can be re-evaluated by multiparametric MRI. As a result, there is increasing evidence that MRI before repeat or even initial biopsy can accurately select patients who require immediate biopsies and those in whom biopsy could be deferred. Also, a relationship between apparent diffusion coefficient (ADC), calculated from DWI, and Gleason score was found. Thus, MRI before biopsy helps to detect high-grade tumors to target biopsies within areas of low ADC values. To achieve good targeting accuracy, transrectal ultrasound (TRUS)-MRI image registration is necessary. Three-dimensional deformable registration is sufficiently accurate to match TRUS and MRI volumes with a topographic precision of 1 mm. Real-time MRI-guided biopsy is another technique under evaluation. Both approaches will allow for increasing acceptance of focal therapies, should these techniques be validated in the future.

Keywords

Prostate cancer Magnetic resonance imaging MRI Multiparametric MRI D’Amico criteria Prebiopsy MRI Transrectal ultrasound TRUS-MRI image fusion 

Notes

Disclosures

No potential conflicts of interest relevant to this article were reported.

References

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • F. Cornud
    • 1
    Email author
  • N. B. Delongchamps
    • 2
  • P. Mozer
    • 3
  • F. Beuvon
    • 4
  • A. Schull
    • 1
  • N. Muradyan
    • 5
  • M. Peyromaure
    • 2
  1. 1.Service de Radiologie, Hôpital CochinParisFrance
  2. 2.Department of UrologyHôpital CochinParisFrance
  3. 3.Department of UrologyHôpital Pitié-SalpétrièreParisFrance
  4. 4.Department of PathologyHôpital CochinParisFrance
  5. 5.iCAD IncNashuaUSA

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