TY - JOUR
T1 - The role of magnetic resonance imaging (MRI) in prostate cancer imaging and staging at 1.5 and 3 Tesla
T2 - The Beth Israel Deaconess Medical Center (BIDMC) approach
AU - Bloch, B. Nicolas
AU - Lenkinski, Robert E.
AU - Rofsky, Neil M.
PY - 2008
Y1 - 2008
N2 - Management decisions for patients with prostate cancer present a dilemma for both patients and their clinicians because prostate cancers demonstrate a wide range in biologic activity, with the majority of cases not leading to a prostate cancer related death. Furthermore, the current treatment options have significant side effects, such as incontinence, rectal injury and impotence. Key elements for guiding appropriate treatment include: distinction of organ-confined disease from extracapsular extension (ECE); and determination of tumor volume and tumor grade, none of which have been satisfactorily accomplished in today's pre-treatment paradigm. Magnetic resonance imaging (MRI) has the capability to assess prostate tissue, both functionally and morphologically. MRI as a staging tool has not shown enough consistency or sufficient accuracy for widespread adoption in clinical practice; yet, recent technical developments in MRI have yielded improved results. At our institution we have combined the use of new endorectal 3 Tesla MRI technology, T2-weighted, and high spatial resolution dynamic-contrast enhanced (DCE) MRI to non-invasively assess the prostate with higher signal-to-noise ratio and spatial resolution than previously achieved. This approach allows assessment of prostate-tissue morphology and kinetics, thus providing a non-invasive tool for tumor detection and staging and, consequently, directing biopsy and treatment specifically to diseased areas for a pre-treatment evaluation that can assist in the rational selection of patients for appropriate prostate cancer therapy.
AB - Management decisions for patients with prostate cancer present a dilemma for both patients and their clinicians because prostate cancers demonstrate a wide range in biologic activity, with the majority of cases not leading to a prostate cancer related death. Furthermore, the current treatment options have significant side effects, such as incontinence, rectal injury and impotence. Key elements for guiding appropriate treatment include: distinction of organ-confined disease from extracapsular extension (ECE); and determination of tumor volume and tumor grade, none of which have been satisfactorily accomplished in today's pre-treatment paradigm. Magnetic resonance imaging (MRI) has the capability to assess prostate tissue, both functionally and morphologically. MRI as a staging tool has not shown enough consistency or sufficient accuracy for widespread adoption in clinical practice; yet, recent technical developments in MRI have yielded improved results. At our institution we have combined the use of new endorectal 3 Tesla MRI technology, T2-weighted, and high spatial resolution dynamic-contrast enhanced (DCE) MRI to non-invasively assess the prostate with higher signal-to-noise ratio and spatial resolution than previously achieved. This approach allows assessment of prostate-tissue morphology and kinetics, thus providing a non-invasive tool for tumor detection and staging and, consequently, directing biopsy and treatment specifically to diseased areas for a pre-treatment evaluation that can assist in the rational selection of patients for appropriate prostate cancer therapy.
KW - Anterior tumors
KW - Dynamic contrast enhanced MRI
KW - Extracapsular extension
KW - Local recurrence
KW - MR Imaging (MRI)
KW - Prostate cancer
KW - Prostate cancer imaging
KW - Repeat negative biopsy
KW - Staging
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U2 - 10.3233/CBM-2008-44-507
DO - 10.3233/CBM-2008-44-507
M3 - Article
C2 - 18957714
AN - SCOPUS:54949122148
SN - 1574-0153
VL - 4
SP - 251
EP - 262
JO - Cancer Biomarkers
JF - Cancer Biomarkers
IS - 4-5
ER -