Evolution of prostate MRI: from multiparametric standard to less-is-better and different-is better strategies

摘要

Application of the Prostate Imaging Reporting and Data System (PI-RADS) version 2 in interpreting a finding in the peripheral zone (PZ) of a biopsy-naïve 62-year-old man undergoing prostate multiparametric magnetic resonance imaging (mpMRI) for elevated prostate specific antigen (PSA) level. The dominant sequence, , a transverse diffusion-weighted imaging (DWI) sequence, showed an area (b = 2000 s/mm image (arrow in ) and corresponding marked hypointensity on the apparent diffusion coefficient (ADC) map ( ). This finding was classified as PI-RADS 4 accordingly, with additional ancillary suspicious features such as hypointensity on transverse T2-weighted imaging ( ) and focal early contrast enhancement on subtracted T1-weighted imaging ( ). Pathology after radical prostatectomy found a Gleason score 7 (3 + 4) T3a N0 cancer