Article

ESUR prostate MR guidelines 2012

Department of Radiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
European Radiology (Impact Factor: 4.01). 04/2012; 22(4):746-57. DOI: 10.1007/s00330-011-2377-y
Source: PubMed

ABSTRACT

The aim was to develop clinical guidelines for multi-parametric MRI of the prostate by a group of prostate MRI experts from the European Society of Urogenital Radiology (ESUR), based on literature evidence and consensus expert opinion. True evidence-based guidelines could not be formulated, but a compromise, reflected by “minimal” and “optimal” requirements has been made. The scope of these ESUR guidelines is to promulgate high quality MRI in acquisition and evaluation with the correct indications for prostate cancer across the whole of Europe and eventually outside Europe. The guidelines for the optimal technique and three protocols for “detection”, “staging” and “node and bone” are presented. The use of endorectal coil vs. pelvic phased array coil and 1.5 vs. 3 T is discussed. Clinical indications and a PI-RADS classification for structured reporting are presented.

Key Points

• This report provides guidelines for magnetic resonance imaging (MRI) in prostate cancer.
• Clinical indications, and minimal and optimal imaging acquisition protocols are provided.
• A structured reporting system (PI-RADS) is described.

Download full-text

Full-text

Available from: Jelle Barentsz
  • Source
    • "Radiology (ESUR) anhand der PI-RADS- Skala (engl. " prostate imaging reporting and data system " ) befundet[6]. Die PI- RADS-Klassifikation stuft auffällige Befunde auf einer Likert-Skala ([7]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background Diffusion-weighted imaging (DWI) is a magnetic resonance imaging (MRI) technique that was established in the clinical routine primarily for the detection of brain ischemia. In the past 15 years its clinical use has been extended to oncological radiology, as tumor and metastases can be depicted in DWI due to their hypercellular nature. Principles The basis of DWI is the Stejskal-Tanner experiment. The diffusion properties of tissue can be visualized after acquisition of at least two diffusion-weighted series using echo planar imaging and a specific sequence of gradient pulses. Clinical applications The use of DWI in prostate MRI was reported to be one of the first established applications that found its way into internationally recognized clinical guidelines of the European Society of Urological Radiology (ESUR) and the prostate imaging reporting and data system (PI-RADS) scale. Due to recently reported high specificity and negative predictive values of 94 % and 92 %, respectively, its regular use for breast MRI is expected in the near future. Furthermore, DWI can also reliably be used for whole-body imaging in patients with multiple myeloma or for measuring the extent of bone metastases. Outlook New techniques in DWI, such as intravoxel incoherent motion imaging, diffusion kurtosis imaging and histogram-based analyses represent promising approaches to achieve a more quantitative evaluation for tumor detection and therapy response.
    Full-text · Article · Jan 2016 · Der Radiologe
  • Source
    • "The results of a retrospective study[18]and one meta-analysis[19]have suggested a higher sensitivity of the choline PET-CT to identify cancer relapse after radical prostatectomy in patients with PSADT ≤ 6. Our incidence of nearly 50 % supports the ESUR recommendation[6]to use mp-MRI to evaluate men with biochemical failure prior to salvage radiotherapy. Regarding location, our results are in line with earlier reports that found that most local recurrences occurred in the perianastomotic area and the retrovesical region[20]. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Little is known about the clinical impact of using multiparametric MRI to plan early salvage radiotherapy after radical prostatectomy. We aimed to evaluate the incidence and location of recurrence based on pelvic multiparametric MRI findings and to identify clinical variables predictive of positive imaging results. Materials and methods We defined radiological criteria of local and lymph node malignancy and reviewed records and MRI studies of 70 patients with PSA recurrence after radical prostatectomy. We performed univariate and multivariate analysis to identify any association between clinical, pathological and treatment-related variables and imaging results. Multiparametric MRI was positive in 33/70 patients. We found local and lymph node recurrence in 27 patients and 7 patients, respectively, with a median PSA value of 0.38 ng/ml. We found no statistically significant differences between patients with positive and negative multiparametric MRI for any variable. Shorter PSADT was associated with positive lymph nodes (median PSADT: 5.12 vs 12.70 months; p: 0.017). Nearly half the patients had visible disease in multiparametric MRI despite low PSA. Positive lymph nodes incidence should be considered when planning salvage radiotherapy, particularly in patients with a short PSADT.
    Full-text · Article · Dec 2015 · Radiation Oncology
    • "However, the number, range, and position of b values used in prostate DWI studies have varied greatly among different studies. Recently, European Society of Urogenital Radiology (ESUR) guidelines recommended the use of at least 3 b values of 0, 100 and 800–1000 s/mm 2 for the monoexponential quantification of prostate DWI signal decay [11]. To our knowledge, clear scientific evidence supporting this recommendation is still missing. "
    [Show abstract] [Hide abstract]
    ABSTRACT: To evaluate the effect of b-value distribution on the repeatability and Gleason score (GS) prediction of prostate cancer (PCa). Fifty PCa patients underwent two repeated 3T diffusion weighted imaging (DWI) examinations using 12 b values in the range from 0 to 2000s/mm(2) and diffusion time of 20.3ms. Mean signal intensities of regions of interest, placed in PCa using whole mount prostatectomy sections as the reference, were fitted using monoexponential, kurtosis, stretched exponential, and biexponential models. In total, 4083 different b-value combinations consisting of 2 to 12 b values were evaluated. Repeatability was assessed by intraclass correlation coefficient, ICC(3,1), and coefficient of repeatability (CoR). Areas under receiver operating characteristic curve (AUCs) for PCa characterization were estimated while the correlation of the fitted values with GS groups (3+3, 3+4, >3+4) was evaluated by using the Spearman correlation coefficient (ρ). The parameters of monoexponential, kurtosis, and stretched exponential models estimated using only 4-5, 5-7, 5-7 b values, respectively, had similar ICC(3,1), CoR, AUC, and ρ values as the parameters estimated using all 12 b values. Optimized b-value distributions demonstrated improved ICC(3,1) and CoR values but failed to improve AUC and ρ values. The parameters of biexponential model demonstrated the worst repeatability and diagnostic performance. B-value distribution influences mainly the repeatability of DWI derived parameters rather than the diagnostic performance. Copyright © 2015. Published by Elsevier Inc.
    No preview · Article · Jul 2015 · Magnetic Resonance Imaging
Show more