mpMRI of the Prostate (MR-Prostatography): Updated Recommendations of the DRG and BDR on Patient Preparation and Scanning Protocol

Abstract

The Working Group Uroradiology and Urogenital Diagnosis of the German Roentgen Society (DRG) revised and updated the recommendations for preparation and scanning protocol of the multiparametric MRI of the Prostate in a consensus process and harmonized it with the managing board of German Roentgen Society and Professional Association of the German Radiologist (BDR e. V.). These detailed recommendation define the referenced “validated quality standards” of the German S3-Guideline Prostate Cancer and describe in detail the topic 1. anamnestic datas, 2. termination of examinations and preparation of examinations, 3. examination protocol and 4. MRI-(in-bore)-biopsy.

Key Points:

• The recommendations for preparation and scanning protocol of the multiparametric MRI of the Prostate were revised and updated in a consensus process and harmonized with the managing board of German Roentgen Society (DRG) and Professional Asssociation of the German Radiologist (BDR).

• Detailed recommendations are given for topic 1. anamnestic datas, 2. termination and preparation of examinations, 3. examination protocoll and 4. MRI-(in-bore)-biopsy.

• These recommendations define the referenced “validated quality standards” of the German S3-Guideline Prostate Cancer.

Citation Format

• Franiel T, Asbach P, Beyersdorff D et al. mpMRI of the Prostate (MR-Prostatography): Updated Recommendations of the DRG and BDR on Patient Preparation and Examination Protocol. Fortschr Röntgenstr 2021; 193: 763 – 776

Key words

prostate - MR-imaging - genital/reproductive - MR-diffusion/perfusion - technical aspects

Publikationsverlauf

Eingereicht: 16. Februar 2021

Angenommen: 04. März 2021

Artikel online veröffentlicht:
18. März 2021

• Literatur

• 1 Leitlinienprogramm Onkologie. Interdisziplinäre Leitlinie der Qualität S3 zur Früherkennung, Diagnose und Therapie der verschiedenen Stadien des Prostatakarzinoms Version 5.1. 2019
• 2 Distler FA, Radtke JP, Bonekamp D. et al The Value of PSA Density in Combination with PI-RADS for the Accuracy of Prostate Cancer Prediction. J Urol 2017; 198: 575-582 DOI: 10.1016/j.juro.2017.03.130.
• 3 Gupta RT, Brown AF, Silverman RK. et al Can Radiologic Staging With Multiparametric MRI Enhance the Accuracy of the Partin Tables in Predicting Organ-Confined Prostate Cancer?. Am J Roentgenol 2016; 207: 87-95 DOI: 10.2214/AJR.15.15878.
• 4 Lai WS, Gordetsky JB, Thomas JV. et al Factors predicting prostate cancer upgrading on magnetic resonance imaging-targeted biopsy in an active surveillance population. Cancer 2017; 123: 1941-1948 DOI: 10.1002/cncr.30548.
• 5 Radtke JP, Wiesenfarth M, Kesch C. et al Combined Clinical Parameters and Multiparametric Magnetic Resonance Imaging for Advanced Risk Modeling of Prostate Cancer-Patient-tailored Risk Stratification Can Reduce Unnecessary Biopsies. Eur Urol 2017; 72: 888-896 DOI: 10.1016/j.eururo.2017.03.039.
• 6 Stonier T, Simson N, Shah T. et al The "Is mpMRI Enough" or IMRIE Study: A Multicentre Evaluation of Prebiopsy Multiparametric Magnetic Resonance Imaging Compared with Biopsy. Eur Urol Focus 2020; DOI: 10.1016/j.euf.2020.09.012.
• 7 Robert Koch Institut (RKI) und Gesellschaft der epidemiologischen Krebsregister in Deutschland (GEKID). Krebs in Deutschland für 2013/14. Berlin: 2017
• 8 Zeegers MP, Jellema A, Ostrer H. Empiric risk of prostate carcinoma for relatives of patients with prostate carcinoma: a meta – analysis. Cancer 2003; 97: 1894-1903
• 9 Mueller-Lisse UG, Swanson MG, Vigneron DB. et al Time-dependent effects of hormone-deprivation therapy on prostate metabolism as detected by combined magnetic resonance imaging and 3D magnetic resonance spectroscopic imaging. Magn Reson Med 2001; 46: 49-57 DOI: 10.1002/mrm.1159.
• 10 Truong H, Logan J, Turkbey B. et al MRI characterization of the dynamic effects of 5alpha-reductase inhibitors on prostate zonal volumes. Can J Urol 2013; 20: 7002-7007
• 11 Franiel T, Ludemann L, Taupitz M. et al MRI before and after external beam intensity-modulated radiotherapy of patients with prostate cancer: the feasibility of monitoring of radiation-induced tissue changes using a dynamic contrast-enhanced inversion-prepared dual-contrast gradient echo sequence. Radiother Oncol 2009; 93: 241-245 DOI: 10.1016/j.radonc.2009.08.016.
• 12 Franiel T, Ludemann L, Rudolph B. et al Evaluation of normal prostate tissue, chronic prostatitis, and prostate cancer by quantitative perfusion analysis using a dynamic contrast-enhanced inversion-prepared dual-contrast gradient echo sequence. Invest Radiol 2008; 43: 481-487 DOI: 10.1097/RLI.0b013e31816b2f63.
• 13 European Society of Urogenital Radiology. ESUR Guidelines on Contrast Agents 10.0. 2018
• 14 Europäische Arzneimittelagentur (EMA) und Bundesinstitut für Arzneimittel und Medizinprodukte (BfArM). Gadolinium-haltige Kontrastmittel: Aktualisierte Empfehlungen nach Bewertung von Gadoliniumablagerungen im Gehirn und anderen Geweben 2018.
• 15 Tsai LL, Grant AK, Mortele KJ. et al A Practical Guide to MR Imaging Safety: What Radiologists Need to Know. Radiographics 2015; 35: 1722-1737 DOI: 10.1148/rg.2015150108.
• 16 Attenberger UI, Rathmann N, Sertdemir M. et al Small Field-of-view single-shot EPI-DWI of the prostate: Evaluation of spatially-tailored two-dimensional radiofrequency excitation pulses. Z Med Phys 2016; 26: 168-176 DOI: 10.1016/j.zemedi.2015.06.013.
• 17 Czarniecki M, Caglic I, Grist JT. et al Role of PROPELLER-DWI of the prostate in reducing distortion and artefact from total hip replacement metalwork. Eur J Radiol 2018; 102: 213-219 DOI: 10.1016/j.ejrad.2018.03.021.
• 18 Ariyanayagam T, Malcolm PN, Toms AP. Advances in Metal Artifact Reduction Techniques for Periprosthetic Soft Tissue Imaging. Semin Musculoskel R 2015; 19: 328-334 DOI: 10.1055/s-0035-1563734.
• 19 Barrett T, Vargas H, Akin O. et al Value of the hemorrhage exclusion sign on T1-weighted prostate MR images for the detection of prostate cancer. Radiology 2012; 263: 751-757
• 20 European Society of Urogenital Radioloy, American College of Radiology. Prostate Imaging – Reporting and Data System Version 2.1. 2019
• 21 Engels RRM, Israel B, Padhani AR. et al Multiparametric Magnetic Resonance Imaging for the Detection of Clinically Significant Prostate Cancer: What Urologists Need to Know. Part 1: Acquisition. Eur Urol 2020; 77: 457-468 DOI: 10.1016/j.eururo.2019.09.021.
• 22 Slough RA, Caglic I, Hansen NL. et al Effect of hyoscine butylbromide on prostate multiparametric MRI anatomical and functional image quality. Clin Radiol 2018; 73: 216 e219-216 e214 DOI: 10.1016/j.crad.2017.07.013.
• 23 Ullrich T, Quentin M, Schmaltz AK. et al Hyoscine butylbromide significantly decreases motion artefacts and allows better delineation of anatomic structures in mp-MRI of the prostate. Eur Radiol 2018; 28: 17-23 DOI: 10.1007/s00330-017-4940-7.
• 24 Roethke MC, Kuru TH, Radbruch A. et al Prostate magnetic resonance imaging at 3 Tesla: Is administration of hyoscine-N-butyl-bromide mandatory?. World J Radiol 2013; 5: 259-263 DOI: 10.4329/wjr.v5.i7.259.
• 25 Wagner M, Rief M, Busch J. et al Effect of butylscopolamine on image quality in MRI of the prostate. Clin Radiol 2010; 65: 460-464 DOI: 10.1016/j.crad.2010.02.007.
• 26 Caglic I, Hansen NL, Slough RA. et al Evaluating the effect of rectal distension on prostate multiparametric MRI image quality. Eur J Radiol 2017; 90: 174-180 DOI: 10.1016/j.ejrad.2017.02.029.
• 27 Lim C, Quon J, McInnes M. et al Does a cleansing enema improve image quality of 3T surface coil multiparametric prostate MRI?. J Magn Reson Imaging 2015; 42: 689-697 DOI: 10.1002/jmri.24833.
• 28 Medved M, Sammet S, Yousuf A. et al MR imaging of the prostate and adjacent anatomic structures before, during, and after ejaculation: qualitative and quantitative evaluation. Radiology 2014; 271: 452-460 DOI: 10.1148/radiol.14131374.
• 29 Kabakus IM, Borofsky S, Mertan FV. et al Does Abstinence From Ejaculation Before Prostate MRI Improve Evaluation of the Seminal Vesicles?. Am J Roentgenol 2016; 207: 1205-1209 DOI: 10.2214/AJR.16.16278.
• 30 Barrett T, Tanner J, Gill AB. et al The longitudinal effect of ejaculation on seminal vesicle fluid volume and whole-prostate ADC as measured on prostate MRI. Eur Radiol 2017; 27: 5236-5243 DOI: 10.1007/s00330-017-4905-x.
• 31 Shin T, Kaji Y, Shukuya T. et al Significant changes of T2 value in the peripheral zone and seminal vesicles after ejaculation. Eur Radiol 2018; 28: 1009-1015 DOI: 10.1007/s00330-017-5077-4.
• 32 Yuruk E, Pastuszak AW, Suggs 3rd JM. et al The association between seminal vesicle size and duration of abstinence from ejaculation. Andrologia 2017; 49 DOI: 10.1111/and.12707.
• 33 Mueller-Lisse UG, Mueller-Lisse UL, Zamecnik P. et al [Diffusion-weighted MRI of the prostate]. Radiologe 2011; 51: 205-214 DOI: 10.1007/s00117-010-2061-2.
• 34 Klingebiel M, Ullrich T, Quentin M. et al Advanced diffusion weighted imaging of the prostate: Comparison of readout-segmented multi-shot, parallel-transmit and single-shot echo-planar imaging. Eur J Radiol 2020; 130: 109161 DOI: 10.1016/j.ejrad.2020.109161.
• 35 Stocker D, Manoliu A, Becker AS. et al Image Quality and Geometric Distortion of Modern Diffusion-Weighted Imaging Sequences in Magnetic Resonance Imaging of the Prostate. Invest Radiol 2018; 53: 200-206 DOI: 10.1097/rli.0000000000000429.
• 36 Thierfelder KM, Scherr MK, Notohamiprodjo M. et al Diffusion-weighted MRI of the prostate: advantages of Zoomed EPI with parallel-transmit-accelerated 2D-selective excitation imaging. Eur Radiol 2014; 24: 3233-3241 DOI: 10.1007/s00330-014-3347-y.
• 37 Quentin M, Schimmoller L, Arsov C. et al Increased signal intensity of prostate lesions on high b-value diffusion-weighted images as a predictive sign of malignancy. Eur Radiol 2014; 24: 209-213 DOI: 10.1007/s00330-013-2999-3.
• 38 Vargas HA, Akin O, Franiel T. et al Diffusion-weighted endorectal MR imaging at 3 T for prostate cancer: tumor detection and assessment of aggressiveness. Radiology 2011; 259: 775-784 DOI: 10.1148/radiol.11102066.
• 39 Decker G, Murtz P, Gieseke J. et al Intensity-modulated radiotherapy of the prostate: dynamic ADC monitoring by DWI at 3.0 T. Radiother Oncol 2014; 113: 115-120 DOI: 10.1016/j.radonc.2014.07.016.
• 40 Jie C, Rongbo L, Ping T. The value of diffusion-weighted imaging in the detection of prostate cancer: a meta-analysis. Eur Radiol 2014; 24: 1929-1941 DOI: 10.1007/s00330-014-3201-2.
• 41 Zhang ZX, Yang J, Zhang CZ. et al The value of magnetic resonance imaging in the detection of prostate cancer in patients with previous negative biopsies and elevated prostate-specific antigen levels: a meta-analysis. Acad Radiol 2014; 21: 578-589 DOI: 10.1016/j.acra.2014.01.004.
• 42 Schimmoller L, Quentin M, Arsov C. et al MR-sequences for prostate cancer diagnostics: validation based on the PI-RADS scoring system and targeted MR-guided in-bore biopsy. Eur Radiol 2014; 24: 2582-2589 DOI: 10.1007/s00330-014-3276-9.
• 43 Wu LM, Xu JR, Ye YQ. et al The clinical value of diffusion-weighted imaging in combination with T2-weighted imaging in diagnosing prostate carcinoma: a systematic review and meta-analysis. Am J Roentgenol 2012; 199: 103-110 DOI: 10.2214/ajr.11.7634.
• 44 Othman AE, Falkner F, Weiss J. et al Effect of Temporal Resolution on Diagnostic Performance of Dynamic Contrast-Enhanced Magnetic Resonance Imaging of the Prostate. Invest Radiol 2016; 51: 290-296 DOI: 10.1097/rli.0000000000000234.
• 45 Othman AE, Falkner F, Martirosian P. et al Optimized Fast Dynamic Contrast-Enhanced Magnetic Resonance Imaging of the Prostate: Effect of Sampling Duration on Pharmacokinetic Parameters. Invest Radiol 2016; 51: 106-112 DOI: 10.1097/rli.0000000000000213.
• 46 Ullrich T, Quentin M, Arsov C. et al Value of Dynamic Contrast-Enhanced (DCE) MR Imaging in Peripheral Lesions in PI-RADS-4 Patients. Rofo 2020; 192: 441-447 DOI: 10.1055/a-1020-4026.
• 47 Sun C, Chatterjee A, Yousuf A. et al Comparison of T2-Weighted Imaging, DWI, and Dynamic Contrast-Enhanced MRI for Calculation of Prostate Cancer Index Lesion Volume: Correlation With Whole-Mount Pathology. Am J Roentgenol 2019; 212: 351-356 DOI: 10.2214/ajr.18.20147.
• 48 Barret E, Turkbey B, Puech P. et al Update on the ICUD-SIU consultation on multi-parametric magnetic resonance imaging in localised prostate cancer. World J Urol 2019; 37: 429-436 DOI: 10.1007/s00345-018-2395-3.
• 49 Bass EJ, Pantovic A, Connor M. et al A systematic review and meta-analysis of the diagnostic accuracy of biparametric prostate MRI for prostate cancer in men at risk. Prostate Cancer and Prostatic Diseases 2020; DOI: 10.1038/s41391-020-00298-w. ; online ahead of prin
• 50 O'Donohoe RL, Dunne RM, Kimbrell V. et al Prostate MRI using an external phased array wearable pelvic coil at 3T: comparison with an endorectal coil. Abdom Radiol (NY) 2019; 44: 1062-1069 DOI: 10.1007/s00261-018-1804-9.
• 51 Baur AD, Daqqaq T, Wagner M. et al T2- and diffusion-weighted magnetic resonance imaging at 3T for the detection of prostate cancer with and without endorectal coil: An intraindividual comparison of image quality and diagnostic performance. Eur J Radiol 2016; 85: 1075-1084 DOI: 10.1016/j.ejrad.2016.03.014.
• 52 Shah ZK, Elias SN, Abaza R. et al Performance comparison of 1.5-T endorectal coil MRI with 3.0-T nonendorectal coil MRI in patients with prostate cancer. Acad Radiol 2015; 22: 467-474 DOI: 10.1016/j.acra.2014.11.007.
• 53 Turkbey B, Merino MJ, Gallardo EC. et al Comparison of endorectal coil and nonendorectal coil T2W and diffusion-weighted MRI at 3 Tesla for localizing prostate cancer: correlation with whole-mount histopathology. J Magn Reson Imaging 2014; 39: 1443-1448 DOI: 10.1002/jmri.24317.
• 54 Mueller-Lisse UG, Scherr MK. Proton MR spectroscopy of the prostate. Eur J Radiol 2007; 63: 351-360 DOI: 10.1016/j.ejrad.2007.06.024.
• 55 Umbehr M, Bachmann LM, Held U. et al Combined magnetic resonance imaging and magnetic resonance spectroscopy imaging in the diagnosis of prostate cancer: a systematic review and meta-analysis. Eur Urol 2009; 55: 575-590 DOI: 10.1016/j.eururo.2008.10.019.
• 56 Polanec SH, Lazar M, Wengert GJ. et al 3D T2-weighted imaging to shorten multiparametric prostate MRI protocols. Eur Radiol 2018; 28: 1634-1641 DOI: 10.1007/s00330-017-5120-5.
• 57 Caglic I, Povalej BrzanP, Warren AY. et al Defining the incremental value of 3D T2-weighted imaging in the assessment of prostate cancer extracapsular extension. Eur Radiol 2019; 29: 5488-5497 DOI: 10.1007/s00330-019-06070-6.
• 58 Ding K, Yao Y, Gao Y. et al Diagnostic evaluation of diffusion kurtosis imaging for prostate cancer: Detection in a biopsy population. Eur J Radiol 2019; 118: 138-146 DOI: 10.1016/j.ejrad.2019.07.009.
• 59 Roethke MC, Kuder TA, Kuru TH. et al Evaluation of Diffusion Kurtosis Imaging Versus Standard Diffusion Imaging for Detection and Grading of Peripheral Zone Prostate Cancer. Invest Radiol 2015; 50: 483-489 DOI: 10.1097/rli.0000000000000155.
• 60 Mai J, Abubrig M, Lehmann T. et al T2 Mapping in Prostate Cancer. Investigative Radiology 2019; 54: 146-152
• 61 Kaufmann S, Russo GI, Bamberg F. et al Prostate cancer detection in patients with prior negative biopsy undergoing cognitive-, robotic- or in-bore MRI target biopsy. World J Urol 2018; 36: 761-768 DOI: 10.1007/s00345-018-2189-7.
• 62 Oberlin DT, Casalino DD, Miller FH. et al Diagnostic Value of Guided Biopsies: Fusion and Cognitive-registration Magnetic Resonance Imaging Versus Conventional Ultrasound Biopsy of the Prostate. Urology 2016; 92: 75-79 DOI: 10.1016/j.urology.2016.02.041.
• 63 Schimmoller L, Blondin D, Arsov C. et al MRI-Guided In-Bore Biopsy: Differences Between Prostate Cancer Detection and Localization in Primary and Secondary Biopsy Settings. Am J Roentgenol 2016; 206: 92-99 DOI: 10.2214/ajr.15.14579.
• 64 Kaufmann S, Kruck S, Kramer U. et al Direct comparison of targeted MRI-guided biopsy with systematic transrectal ultrasound-guided biopsy in patients with previous negative prostate biopsies. Urol Int 2015; 94: 319-325 DOI: 10.1159/000365397.
• 65 Arsov C, Rabenalt R, Blondin D. et al Prospective randomized trial comparing magnetic resonance imaging (MRI)-guided in-bore biopsy to MRI-ultrasound fusion and transrectal ultrasound-guided prostate biopsy in patients with prior negative biopsies. Eur Urol 2015; 68: 713-720 DOI: 10.1016/j.eururo.2015.06.008.
• 66 Durmus T, Reichelt U, Huppertz A. et al MRI-guided biopsy of the prostate: correlation between the cancer detection rate and the number of previous negative TRUS biopsies. Diagn Interv Radiol 2013; 19: 411-417 DOI: 10.5152/dir.2013.13055.
• 67 Rastinehad AR, Durand M. A comparison of magnetic resonance imaging and ultrasonography (MRI/US)-fusion guided prostate biopsy devices: too many uncontrolled variables. BJU Int 2016; 117: 548-549 DOI: 10.1111/bju.13344.
• 68 Patel IJ, Rahim S, Davidson JC. et al Society of Interventional Radiology Consensus Guidelines for the Periprocedural Management of Thrombotic and Bleeding Risk in Patients Undergoing Percutaneous Image-Guided Interventions-Part II: Recommendations: Endorsed by the Canadian Association for Interventional Radiology and the Cardiovascular and Interventional Radiological Society of Europe. J Vasc Interv Radiol 2019; 30: 1168-1184 e1161 DOI: 10.1016/j.jvir.2019.04.017.
• 69 Chee YL, Crawford JC, Watson HG. et al Guidelines on the assessment of bleeding risk prior to surgery or invasive procedures. British Committee for Standards in Haematology. Br J Haematol 2008; 140: 496-504 DOI: 10.1111/j.1365-2141.2007.06968.x.
• 70 Burger W, Chemnitius JM, Kneissl GD. et al Low-dose aspirin for secondary cardiovascular prevention – cardiovascular risks after its perioperative withdrawal versus bleeding risks with its continuation – review and meta-analysis. J Intern Med 2005; 257: 399-414 DOI: 10.1111/j.1365-2796.2005.01477.x.
• 71 Poldermans D, Bax JJ, Boersma E. et al Guidelines for pre-operative cardiac risk assessment and perioperative cardiac management in non-cardiac surgery: the Task Force for Preoperative Cardiac Risk Assessment and Perioperative Cardiac Management in Non-cardiac Surgery of the European Society of Cardiology (ESC) and endorsed by the European Society of Anaesthesiology (ESA). Eur J Anaesthesiol 2010; 27: 92-137 DOI: 10.1097/EJA.0b013e328334c017.
• 72 Patel IJ, Davidson JC, Nikolic B. et al Addendum of newer anticoagulants to the SIR consensus guideline. J Vasc Interv Radiol 2013; 24: 641-645 DOI: 10.1016/j.jvir.2012.12.007.
• 73 Bootsma AM, Laguna Pes MP, Geerlings SE. et al Antibiotic prophylaxis in urologic procedures: a systematic review. Eur Urol 2008; 54: 1270-1286 DOI: 10.1016/j.eururo.2008.03.033.
• 74 Loeb S, Carter HB, Berndt SI. et al Complications after prostate biopsy: data from SEER-Medicare. J Urol 2011; 186: 1830-1834 DOI: 10.1016/j.juro.2011.06.057.