Multiparametric magnetic resonance imaging of the prostate at 1.5-Tesla without endorectal coil: Can it be used to detect clinically significant prostate cancer in men with medical devices that are contraindicated at 3-Tesla?

摘要

Multi-parametric (mp) MRI is accurate for detection of clinically significant (International Society of Urogenital Pathology [ISUP] grade group ≥2) prostate cancer (CS-PCa) (1). Imaging quality is crucial for accurate mp-MRI and should be compliant with Prostate Imaging and Data Reporting System (PI-RADS) specifications (2,3). mp-MRI can be performed without endorectal coil (ERC) at 3-Tesla (T) (4,5) which improves patient tolerance, ease of use and imaging artifact (5). 1.5-Tesla mp-MRI without ERC is more controversial. PI-RADS version 2 suggests imaging at 3T should be performed over 1.5T whenever possible and ERC may be indispensable at 1.5T (2); however, it is acknowledged that credible results have been obtained at 1.5T without ERC (6). There remains a subset of men in whom 3T imaging is contraindicated; where 1.5T imaging is required, namely those with uncleared (MRI unsafe) medical devices for 3T. At institutions, such as our own, who now perform mp-MRI exclusively without ERC at 3T, accessibility and experience with ERC for 1.5T mp-MRI is limited. This study evaluates the accuracy for detecting CS-PCa using 1.5T mp-MRI without ERC in men with uncleared medical devices for 3T.