Division of Abdominal Imaging, Massachusetts General Hospital, Boston, MA, USA.
Section of Abdominal Imaging and Nuclear Radiology Department, Imaging Institute, Cleveland Clinic, 9500 Euclid Avenue, Mail Code JB-322, Cleveland, OH, 44145, USA.
Abdom Radiol (NY). 2020 Dec;45(12):3997-4002. doi: 10.1007/s00261-020-02456-z.
Biparametric MRI (bpMRI), which uses only T2-weighted imaging and diffusion-weighted imaging, continues to gain support for the detection of prostate cancer, as this imaging technique offers many benefits over traditional mpMRI. However, the Prostate Imaging Reporting and Data System (PI-RADS) v2.1 document released in 2019 emphasized that mpMRI is still preferred over bpMRI in most clinical scenarios. As one article in a series of four providing arguments for and against using mpMRI and bpMRI protocols, this paper provides arguments against using mpMRI. Within this article, we discuss recent data suggesting equivalent performance between bpMRI and mpMRI in the detection of prostate cancer. The limited utility of dynamic contrast enhancement in the evaluation of prostate cancer according to the PI-RADS v2.1 document is also reviewed. Finally, we detail the large financial and time costs, legal and logistical issues, and potential for patient harm that must be considered with the administration of contrast.
双参数 MRI（bpMRI）仅使用 T2 加权成像和扩散加权成像，继续为前列腺癌的检测提供支持，因为这种成像技术比传统的 mpMRI 具有许多优势。然而，2019 年发布的前列腺影像报告和数据系统（PI-RADS）v2.1 文档强调，在大多数临床情况下，mpMRI 仍然优于 bpMRI。作为一系列四篇文章中的一篇，本文针对使用 mpMRI 和 bpMRI 方案提供了支持和反对的论点，本文提供了反对使用 mpMRI 的论点。在本文中，我们讨论了最近的数据，这些数据表明 bpMRI 和 mpMRI 在检测前列腺癌方面的表现相当。根据 PI-RADS v2.1 文档，动态对比增强在评估前列腺癌方面的有限效用也进行了回顾。最后，我们详细说明了在使用造影剂时必须考虑的大量财务和时间成本、法律和后勤问题以及患者伤害的潜在风险。
