Pitfalls in multiparametric prostate MRI

Author(s): Dr Steven Kennish, Dr Rachel Hubbard

Hospital: Sheffield Teaching Hospitals NHS Foundation Trust, University College London Hospitals NHS Foundation Trust

Reference: RAD Magazine, 46, 545, 26-28

Excerpt: 

Multiparametric prostate MRI (mpMRI) is now established as the gold standard first-line investigation for identifying potentially curative prostate cancer. It is routinely requested for men with a persistently raised PSA blood test (in the absence of a urinary tract infection) and/or concerns identified on a digital rectal examination of the prostate. The threshold for requesting mpMRI may be further reduced in the context of a positive family history for prostate cancer.

The established diagnostic utility of the scan combined with patient acceptability and an ageing patient population have culminated in a greatly increased demand for this investigation. This necessitates the training of appropriately qualified radiologists to provide high quality image interpretation and reporting using either a PI-RADS or Likert score. The score helps risk stratify patients and guides whether to biopsy and which biopsy technique to use.

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