Roughly 14% of American men will be diagnosed with prostate cancer (PCa) in their lifetime. It is the second leading cause of death in men, after lung cancer—yet it is a highly curable disease if caught early, and if choice of treatment matches the disease.
This year, over 220,000 new cases will be diagnosed. Today, the technologic advances in imaging, especially multiparametric MRI, give PCa patients good reason to be optimistic. While ultrasound and color Doppler ultrasound have been used for decades to gain pictorial information and guide treatment, today’s mpMRI excels at what Dr. Mark Emberton calls “interrogating the prostate gland.” What that means is that an experienced reader using a powerful 3 Tesla (3T) magnet can use imaging to answer the following questions:
- Is a tumor (or more than one tumor) present?
- Where is it?
- What is the size?
- What is the shape?
- What is the level of aggression (is it significant or insignificant)?
In clinical terms, this means we can detect, localize and stage a patient’s disease. When used in connection with other clinical factors such as PSA and its variants, targeted biopsy, Gleason score, and molecular biomarkers as indicated, we have a portrait of a cancer that allows patient and doctor to make the best treatment decision.
A recent review of imaging from a group of German authors summarizes the advantages of mpMRI. In terms of the above questions, the writers state, “The best method for answering these questions is multiparametric MRI.”[i] They also point to PI-RADS, the 5-point scale called the Prostate Imaging—Reporting and Data System that is moving us closer to standardizing how mpMRI is reported (see also https://sperlingprostatecenter.com/pi-rads-score/ and https://sperlingprostatecenter.com/testing-pi-rads-accuracy/.) A newer version of PI-RADS (PI-RADSv2) is even more user-friendly than the original.
The interdisciplinary German team (radiology and urology) has affirmed that we provide our patients with the best imaging modality available for visually examining the prostate gland and surrounding structures. It is reassuring to know that our Center is and has been at the vanguard of prostate imaging with 3T mpMRI.
[i] Franiel T, Asbach P, Teichgräber U et?al. Prostate Imaging – An Update. Rofo. 2015 Sep;187(9):751-759.
About Dr. Dan Sperling
Dan Sperling, MD, DABR, is a board certified radiologist who is globally recognized as a leader in multiparametric MRI for the detection and diagnosis of a range of disease conditions. As Medical Director of the Sperling Prostate Center, Sperling Medical Group and Sperling Neurosurgery Associates, he and his team are on the leading edge of significant change in medical practice. He is the co-author of the new patient book Redefining Prostate Cancer, and is a contributing author on over 25 published studies. For more information, contact the Sperling Prostate Center.
