Prostate MRI Essentials

This book is a basic, practical guide to performing and interpreting state-of-the-art prostate MRI, utilizing the latest guidelines in the field. Prostate MRI has become one of the fastest growing examinations in the radiology practice, and this demand has continuously increased within the past decade. Since it is relatively new, MRI of the prostate is predominantly being performed at academic institutions, however there is a growing demand within the lower-tier health care institutions to offer this examination to their patients. This is an ideal guide for radiologists who want to enhance or initiate prostate MRI service for their referring clinicians and as a manual for technologists and those who are in training.

Prostate cancer is the second leading cause of cancer death in men, exceeded only by lung cancer. The best predictor of disease outcome lies with correct diagnosis, which requires precise imaging and diagnostic procedures aided by prostate MRI. Urologists, medical oncologists and radiation oncologists all agree that multi-parametric prostate MRI is essential for evaluation of prostate cancer. However, the technical aspects of prostate MR imaging are not as straightforward as for the other imaging modalities and constantly evolving. Its small size presents a real challenge to the radiologist, who needs to do the T2 and diffusion weighted images and perform a dynamic contrast enhanced sequence correctly. These images may also need to be analyzed on an independent workstation. Due to the absence of a current reference manual, when a radiologist wants to establish a prostate imaging service, he/she needs to attend dedicated prostate MR workshops or dive into the literature search alone, only to get more confused about what to do and how to do it.

With this book, expert authors were asked to give clear guidance to those who want to enhance or initiate their prostate imaging service. With this much-needed, concise, practical guidance, radiologists can perform and interpret multi-parametric prostate MRI in a standardized fashion, in concordance with PI-RADS v2.1 that can be applicable to all available hardware platforms (GE, Philips, Siemens, Toshiba). Additionally, they can perform post-processing for possible targeted biopsy and interpret post-therapy and PET studies. The book discusses imaging protocols (planning and prescription) and sequence parameters with representative images for each MRI sequence. This handbook-style practical manual can be used in the radiology reading room by those interpreting the MR exam as a reference as well as at the MRI scanner by the technologists as a guide. Coverage of basic prostate anatomy, pathology, Urologists’ point of view, MRI guided radiation treatment planning and molecular imaging is also included. Throughout the book, authors will discuss basics, pitfalls, and provide tips in image acquisition and interpretation, alongside several case examples.