Prostate Cancer: Diagnosis and evaluation: Difference between revisions

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 **'''<span style="color:#ff0000">T2WI</span>'''
 **'''<span style="color:#ff0000">DWI with ADC maps</span>'''
-*'''Bi-parametric MRI (bpMRI)'''
-**'''Combination of T2WI and DWI (with ADC maps)'''
-**Advantages
-***Fewer sequences reduces time/costs to complete study
-**'''No significant difference in sensitivity or specificity compared to mpMRI'''
-***Systematic review and meta-analysis (2018)
-****20 studies involving 2142 patients
-****Results
-*****No significant difference in pooled sensitivity and specificity
-******Sensitivity: 0.74 (95% CI, 0.66–0.81) bpMRI vs. 0.76 (95% CI, 0.69–0.82) mpMRI
-******Specificity: 0.90 (95% CI, 0.86–0.93) bpMRI vs. 0.89 (95% CI, 0.85–0.93) mpMRI
-****[https://pubmed.ncbi.nlm.nih.gov/30240296/ Woo, Sungmin, et al.] "Head-to-head comparison between biparametric and multiparametric MRI for the diagnosis of prostate cancer: a systematic review and meta-analysis." ''American Journal of Roentgenology'' (2018): W226-W241.
 * '''<span style="color:#ff0000">T2WI</span>'''
 ** '''Captures the movement of protons in the xy-axis (transverse)'''
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 ** '''<span style="color:#ff0000">When combined with T2WI, MRSI has been found to have the highest sensitivity of all MRI sequences (92%) in detecting prostate cancer.</span>'''
 ** While MRSI is a promising imaging sequence, it requires an extra 10 to 15 minutes of examination time. Also, for this phase an endorectal coil (see below) is mandatory at 1.5T and optional at 3T. For these reasons, MRSI is less commonly performed than other mpMRI sequences in prostate MRI studies.
-* '''Biparametric MRI'''
+* '''Bi-parametric MRI (bpMRI)'''
-** A limitation of mpMRI for implementation as an adjunct tool for prostate cancer screening is the time required to complete the study, including the placement of an endorectal coil and the use of gadolinium based contrast agents requiring intravenous access. To overcome these limitations, it has been suggested that a '''limited mpMRI study incorporating only non-contrast T2WI and DWI series be performed.'''
+** '''Combination of only non-contrast T2WI and DWI (with ADC maps) series'''
-** This biparametric MRI requires less than half the in-bore magnet time to perform compared with the complete mpMRI, can be performed without an endorectal coil, and obviates the need for intravenous access and contrast administration.
+**Advantages[https://pubmed.ncbi.nlm.nih.gov/26594835/]
+***Can be performed without an endorectal coil
+***Can be performed intravenous access and contrast administration
+***Fewer sequences reduces time/costs to complete study
+****Requires less than half the in-bore magnet time to perform compared with the complete mpMRI
+**Disadvantages
+***Fewer imaging sequences which may limit adequate interpretation
+**'''No significant difference in sensitivity or specificity compared to mpMRI'''
+***Systematic review and meta-analysis (2018)
+****20 studies involving 2142 patients
+****Results
+*****No significant difference in pooled sensitivity and specificity
+******Sensitivity: 0.74 (95% CI, 0.66–0.81) bpMRI vs. 0.76 (95% CI, 0.69–0.82) mpMRI
+******Specificity: 0.90 (95% CI, 0.86–0.93) bpMRI vs. 0.89 (95% CI, 0.85–0.93) mpMRI
+****[https://pubmed.ncbi.nlm.nih.gov/30240296/ Woo, Sungmin, et al.] "Head-to-head comparison between biparametric and multiparametric MRI for the diagnosis of prostate cancer: a systematic review and meta-analysis." ''American Journal of Roentgenology'' (2018): W226-W241.
 ====== <span style="color:#ff0000">Magnet strength</span> ======