Introduction to Multiparametric MR of the Prostate

Imaging

• Multiparametric MR (mpMR)

  • Combination of anatomical and functional imaging

  • Anatomical imaging

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      T2WI

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        Lesion detection and characterization; gland volume and extraprostatic extension

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      T1WI

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        Rule out prostatic hemorrhage (tumor mimicker)

  • Functional imaging

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      Diffusion-weighted imaging (DWI)

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      Apparent diffusion coefficient map (ADC)

      • □

        Interpretation of combined high b-value (≥ 1,400 s/mm²) DWI and ADC map

      • □

        Lesion detection and characterization

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      Dynamic contrast-enhanced (DCE) study

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        Multiple T1WI obtained during and after IV injection of contrast

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        Lesion detection and characterization

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        Key sequence for assessment of tumor recurrence

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      MR spectroscopy (MRS)

      • □

        Key metabolic compounds in prostate gland: Citrate [2.60 parts per million (ppm)]; creatine (3.04 ppm); choline (3.20 ppm)

  • Technical notes

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      Scanner: ≥ 1.5T

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      Coils: Surface multichannel phased array ± endorectal

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      At least 6 weeks after prostate biopsy

• Normal prostate gland

  • Peripheral zone

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      70% of gland volume

    • –

      High and homogeneous signal intensity (SI) on T2WI

  • Transition zone

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      5% of gland volume

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      In benign prostatic hyperplasia (BPH), volume increases and SI on T2WI is heterogeneous ("organized chaos")

  • Central zone: 25% of gland volume (↓ in BPH)