The role of magnetic resonance imaging (MRI) in prostate cancer imaging and staging at 1.5 and 3 Tesla: The Beth Israel Deaconess Medical Center (BIDMC) approach

B. Nicolas Bloch, Robert E. Lenkinski, Neil M. Rofsky

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)251-262
Number of pages12
JournalCancer Biomarkers
Volume4
Issue number4-5
DOIs
StatePublished - 2008

Keywords

  • Anterior tumors
  • Dynamic contrast enhanced MRI
  • Extracapsular extension
  • Local recurrence
  • MR Imaging (MRI)
  • Prostate cancer
  • Prostate cancer imaging
  • Repeat negative biopsy
  • Staging

ASJC Scopus subject areas

  • Oncology
  • Genetics
  • Cancer Research

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