Optimized biparametric magnetic resonance imaging protocol for prostate cancer detection

Abstract

BACKGROUND: Prostate cancer is one of the most commonly diagnosed cancers in men worldwide. PI-RADS v2.1 contains the requirements for the magnetic resonance imaging protocol, which cannot be fully implemented on a significant component of functioning scanners. Consequently, magnetic resonance imaging approaches vary in different medical organizations and often do not allow for a qualitative interpretation of images and diagnosis of the target pathology. AIM: To develop a biparametric magnetic resonance imaging protocol optimized for the existing magnetic resonance imaging scanners for the diagnosis of prostate cancer and to allow the screening and detection of neoplasms as early as possible. Simultaneously, the protocol should fulfill the current PI-RADS v2.1 recommendations to the maximum possible extent and meet the requirements of effective workflow in the radiology department. MATERIALS AND METHODS: Preliminary analysis of prostate magnetic resonance imaging scanning in medical organizations of the Moscow Health Care Department showed the absence of a unified approach. Using the iterative adjustment of scanning parameters, we adjusted the protocol to ensure acceptable quality with maximum available compliance with PI-RADS v2.1. To quantify the quality of the images, we used the magnetic resonance imaging phantom recommended by the American College of Radiology. RESULTS: The biparametric protocol was developed for Excelart Vantage 1.5 T, including T2-weighted images in three planes and diffusion-weighted images, which took less than 11 min. Moreover, the image quality parameters (intensity inhomogeneity, nonlinearity, resolution, and slice thickness) were within the acceptable ranges recommended by the magnetic resonance imaging manufacturer. CONCLUSION: The prostate may be effectively evaluated using the proposed magnetic resonance imaging protocol. Introducing it into practice could have a significant impact on the detection of prostate cancer in men. The entire duration of the protocol provides a possibility to supplement it with any sequences, depending on the final purpose of investigation.