Sadhna Verma, MD, presented “Prostate MRI for the Urologist” during the 2022 Frontiers in Oncologic Prostate Care and Ablative Local Therapy symposium on September 23, 2022, in Los Angeles, California.
How to cite: Sadhna, Verma. “Prostate MRI for the Urologist.” September 23, 2022. Accessed Dec 2023. https://grandroundsinurology.com/prostate-mri-for-the-urologist/
Prostate MRI for the Urologist – Summary
Sadhna Verma, MD, discusses the importance of completing a high-quality prostate MRI as well as a multi-parametric (mp) MRI. An mp-MRI is a combination of techniques including DCE, TW2, and DWI. Today’s MRIs can display the prostate zones very clearly. She discusses the zonal anatomy you can view with DTE, TW2 and T1W, and DWI methods and the strengths and limitations of each. It is important to understand the anatomy, biology, and vascularity of the mp-MRI to accurately interpret imaging. Dr. Verma describes that anatomy can be interpreted from T2W, biology from DWI, and vascularity from DCE. The key steps for success in a mp-MRI include acquisition, interpretation, and targeted biopsy. However, quality of the MRI precludes success. Dr. Verma explains that prostate imaging was introduced in the ESUR prostate MR guidelines in 2012 and is now globally recognized. An issue with acquiring these images is rectal gas and a reexamination may be required if there is motion during imaging. When acquiring, she mentions that PI-RADS categories, which are now at version 2.1, set the standards for MRI. However, when an image is unclear due to motion or speed, repetition is important to gain more clarity. Dr. Verma states that 3T magnetic field strength is preferable, but steep gradients are more important. The key is to use the strongest gradients possible to increase image quality, especially with DWI. Looking at multiple views with good contrast is also important. Lastly, Dr. Verma reviews image examples and reviews limitations of each image.
The annual symposium on Frontiers in Oncologic Prostate Care and Ablative Local Therapy (FOCAL) is an outstanding program on prostate imaging, transperineal interventions, and ablative treatments for prostate cancer and benign prostatic hyperplasia. Bringing together community-based, academic, and industry partners, FOCAL offers lectures by world-renowned faculty and hands-on training workshops on in-office transperineal interventions, fusion-guided prostate ablation and state-of-the-art BPH management with novel technologies. For more educational activities from the symposium that took place from September 23-24, 2022 in Los Angeles, California, visit our collection page.