PI-RADS Committee Position on MRI Without Contrast Medium in Biopsy-Naive Men With Suspected Prostate Cancer: Narrative Review
Year: 2020
Type: review
Abstract: The steadily increasing demand for diagnostic prostate MRI has led to concerns regarding the lack of access to and the availability of qualified MRI scanners and sufficiently experienced radiologists, radiographers, and technologists to meet the demand. Solutions must enhance operational benefits without compromising diagnostic performance, quality, and delivery of service. Solutions should also mitigate risks such as decreased reader confidence and referrer engagement. One approach may be the implementation of MRI without the use gadolinium-based contrast medium (bipara-metric MRI), but only if certain prerequisites such as high-quality imaging, expert interpretation quality, and availability of patient recall or on-table monitoring are mandated. Alternatively, or in combination, a clinical risk-based approach could be used for protocol selection, specifically, which biopsy-naive men need MRI with contrast medium (multiparametric MRI). There is a need for prospective studies in which biopsy decisions are made according to MRI without contrast enhancement. Such studies must define clinical and operational benefits and identify which patient groups can be scanned successfully without contrast enhancement. These higher-quality data are needed before the Prostate Imaging Reporting and Data System (PI-RADS) Committee can make evidence-based recommendations about MRI without contrast enhancement as an initial diagnostic approach for prostate cancer workup.
DOI: 10.2214/ajr.20.24268
Institutions: Erasmus MC, The Netherlands Cancer Institute, Erasmus MC Cancer Institute, Radboud University Nijmegen, Radboud University Medical Center, Universidade Federal Fluminense, University Health Network, University of Toronto, Sinai Health System, Johns Hopkins University, Johns Hopkins Medicine, Weill Cornell Medicine, University College Hospital, University College London Hospitals NHS Foundation Trust, University of Chicago, University of Chicago Medical Center, Sapienza University of Rome, University of Maryland, Baltimore, Brigham and Women's Hospital, National Institutes of Health, National Cancer Institute, Ghent University Hospital, Yale University, Mount Vernon Cancer Centre
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W3078614411