Prostate cancer MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Syed Musadiq Ali M.B.B.S.[2]

Overview

MRI may be helpful in the diagnosis of prostate cancer. MRI-guided prostate biopsy is also being used, particularly in those cases where TRUS biopsy is negative but clinical and PSA suspicion remains high. Following radical prostatectomy, patients with elevated PSA should also be examined using MRI. On MRI scan, T1 image is useful for detection of prostate contour, neurovascular bundle encasement, and post-biopsy hemorrhage. T2-weighted images prostate cancer usually appears as a region of low signal within a normally high signal peripheral zone

MRI

Pelvic MRI may be helpful in the diagnosis of prostate cancer. Findings on MRI suggestive of prostate cancer include:

• T1

• Useful for detection of prostate contour, neurovascular bundle encasement, and post-biopsy hemorrhage

• T2

• Using a endorectal coil, on T2-weighted images prostate cancer usually appears as a region of low signal within a normally high signal peripheral zone
• Most significant cancers occur along the posterior portion of the gland abutting the rectum

• DWI

• Often shows restricted diffusion

• Dynamic contrast enhancement (DCE)

• Shows enhancement - but it can be difficult to distinguish from prostatitis or benign prostatic hyperplasia (especially in the central zone lesions)
• More specific than T2 signal

MRI scan showing prostate cancer source:Case courtesy of Dr Paresh K Desai , Radiopaedia.org, rID: 6650

MRI scan showing prostate cancer source:Case courtesy of Dr Chris O'Donnell, Radiopaedia.org, rID: 19238