Delayed Ferumoxtran-10-Enhanced Magnetic Resonance Neurography of the Lumbosacral Plexus: Impact on Vascular Suppression and Image Quality.

Background: Intravenous Ferumoxtran-10 belongs to ultra-small superparamagnetic iron oxide particles and can be used for magnetic resonance neurography (MRN) as an alternative to other imaging methods which use contrast agents.

Purpose: To examine the impact of intravenous Ferumoxtran-10 on vascular suppression and compare image quality to gadolinium (Gd)-enhanced image acquisition in MRN of lumbosacral plexus (LS).

Study Type: Prospective.

AI-based automated evaluation of image quality and protocol tailoring in patients undergoing MRI for suspected prostate cancer.

Purpose: To develop and validate an artificial intelligence (AI) application in a clinical setting to decide whether dynamic contrast-enhanced (DCE) sequences are necessary in multiparametric prostate MRI.

Methods: This study was approved by the institutional review board and requirement for study-specific informed consent was waived. A mobile app was developed to integrate AI-based image quality analysis into clinical workflow.

Focal therapy with high-intensity focused ultrasound for prostate cancer: 3-year outcomes from a prospective trial.

Objective: To assess the oncological and functional outcomes of focal high-intensity focused ultrasound (HIFU) in treating localised prostate cancer (PCa), a 3-year prospective study was undertaken using periodic post-ablation saturation biopsies.

Patients And Methods: Men with two or fewer lesions of grade group (GG) ≤3 PCa were eligible for participation. Additional criteria included a prostate-specific antigen (PSA) level of ≤15 ng/mL, clinical T1c-T2, and a life expectancy of ≥10 years.

Prediction of pelvic lymph node metastases and PSMA PET positive pelvic lymph nodes with multiparametric MRI and clinical information in primary staging of prostate cancer.

Purpose: To compare the accuracy of multiparametric MRI (mpMRI), Ga-PSMA PET and the Briganti 2019 nomogram in the prediction of metastatic pelvic lymph nodes (PLN) in prostate cancer, to assess the accuracy of mpMRI and the Briganti nomogram in prediction of PET positive PLN and to investigate the added value of quantitative mpMRI parameters to the Briganti nomogram.

Method: This retrospective IRB-approved study included 41 patients with prostate cancer undergoing mpMRI and Ga-PSMA PET/CT or MR prior to prostatectomy and pelvic lymph node dissection. A board-certified radiologist assessed the index lesion on diffusion-weighted (Apparent Diffusion Coefficient, ADC; mean/volume), T2-weighted (capsular contact length, lesion volume/maximal diameters) and contrast-enhanced (iAUC, k, K, v) sequences.

Index lesion contouring on prostate MRI for targeted MRI/US fusion biopsy - Evaluation of mismatch between radiologists and urologists.

Purpose: Mistargeting of focal lesions due to inaccurate segmentations can lead to false-negative findings on MRI-guided targeted biopsies. The purpose of this retrospective study was to examine inter-reader agreement of prostate index lesion segmentations from actual biopsy data between urologists and radiologists.

Method: Consecutive patients undergoing transperineal MRI-targeted prostate biopsy for PI-RADS 3-5 lesions between January 2020 and December 2021 were included.

Multi-reader evaluation of different image quality scoring systems in prostate MRI.

Objectives: To evaluate different image quality scoring systems in the assessment of factors limiting diagnostic accuracy of prostate MRI.

Methods: This retrospective IRB-approved study included 281 patients undergoing prostate MRI prior to biopsy. Four readers (2 experienced, 2 novice) independently reviewed all MRI examinations (n = 295) and assigned scores for subjective image quality (1-5; 1:poor, 5:excellent), the PI-QUAL and the PSHS scoring system.

Abbreviated MR Protocols in Prostate MRI.

Prostate MRI is an integral part of the clinical work-up in biopsy-naïve patients with suspected prostate cancer, and its use has been increasing steadily over the last years. To further its general availability and the number of men benefitting from it and to reduce the costs associated with MR, several approaches have been developed to shorten examination times, e.g.

Primary staging in patients with intermediate- and high-risk prostate cancer: Multiparametric MRI and Ga-PSMA-PET/MRI - What is the value of quantitative data from multiparametric MRI alone or in conjunction with clinical information?

Purpose: Comparing mpMRI and Ga-PSMA-PET/MRI in primary staging of PCa and investigating the value of quantitative mpMRI-measurements for prediction of extracapsular extension and N-metastases.

Methods: Patients with PCa undergoing Ga-PSMA-PET/MRI and mpMRI during January 2016 to February 2019 were retrospectively included. Two readers each on Ga-PSMA-PET/MRI or mpMRI rated extraprostatic extension (≥T3) and regional lymph-node-metastasis (N1) on a Likert-scale.

Improving workflow in prostate MRI: AI-based decision-making on biparametric or multiparametric MRI.

Objectives: To develop and validate an artificial intelligence algorithm to decide on the necessity of dynamic contrast-enhanced sequences (DCE) in prostate MRI.

Methods: This study was approved by the institutional review board and requirement for study-specific informed consent was waived. A convolutional neural network (CNN) was developed on 300 prostate MRI examinations.

[PI-RADS 2.1 and structured reporting of magnetic resonance imaging of the prostate].

Clinical/methodological Issue: The detection of clinically significant prostate cancers while simultaneously avoiding over-diagnosing tumors with low malignant potential is a challenge in clinical practice.

Standard Radiological Methods: Multiparametric prostate magnetic resonance imaging (MRI) in accordance with the Prostate Imaging Reporting and Data System (PI-RADS) guidelines is accepted as standard-of-care with both urologists and radiologists.

Methodological Innovations: The PI-RADS guidelines have been updated to version 2.

Realistic Kidney Tissue Surrogates for Multienergy Computed Tomography-Feasibility and Estimation of Energy-Dependent Attenuation Thresholds for Renal Lesion Enhancement in Low-kV and Virtual Monoenergetic Imaging.

Purpose: The aims of this study were to assess if kidney tissue surrogates (KTSs) are superior to distilled water-iodine solutions in the emulation of energy-dependent computed tomography (CT) attenuation characteristics of renal parenchyma and to estimate attenuation thresholds for definite lesion enhancement for low-kV single-energy and low-keV dual-energy virtual monoenergetic imaging.

Methods: A water-filled phantom (diameter, 30 cm) with multiple vials was imaged on a dual-source dual-energy CT (DS-DE) and a single-source split-filter dual-energy CT (SF-DE), both in single-energy mode at 80, 100, 120, 140 kVp and in dual-energy mode at 80/Sn150, 90/Sn150, and 100/Sn150 kVp for DS-DE and AuSn120 kVp for SF-DE. Single-energy images, linear-blended dual-energy images, and virtual monoenergetic imaging at energy levels from 40 to 190 keV were reconstructed.

Value of an online PI-RADS v2.1 score calculator for assessment of prostate MRI.

Purpose: To evaluate the value of a browser-based PI-RADS Score Calculator (PCalc) compared to MRI reporting using the official PI-RADS v2.1 document (PDoc) for non-specialized radiologists in terms of reporting efficiency, interrater agreement and diagnostic accuracy for detection of clinically significant prostate cancer (PCa).

Methods: Between 09/2013 and 04/2015, 100 patients (median age, 64.

Impact of different phased-array coils on the quality of prostate magnetic resonance images.

Purpose: To evaluate the influence of body phased-array (BPA) receive coil setups on signal-to-noise ratio (SNR) and image quality (IQ) in prostate MRI.

Methods: This prospective study evaluated axial T2-weighted images (T2W-TSE) and DWI of the prostate in ten healthy volunteers with 18-channel (18CH), 30-channel and 60-channel (60CH) BPA receive coil setups. SNR and ADC values were assessed in the peripheral and transition zones (TZ).

Diagnostic performance of Ga-PSMA-11 PET/MRI-guided biopsy in patients with suspected prostate cancer: a prospective single-center study.

Purpose: Ultrasound-guided biopsy (US biopsy) with 10-12 cores has a suboptimal sensitivity for clinically significant prostate cancer (sigPCa). If US biopsy is negative, magnetic resonance imaging (MRI)-guided biopsy is recommended, despite a low specificity for lesions with score 3-5 on Prostate Imaging Reporting and Data System (PIRADS). Screening and biopsy guidance using an imaging modality with high accuracy could reduce the number of unnecessary biopsies, reducing side effects.

Dynamic contrast enhancement in prostate MRI as predictor of erectile function and recovery after radical prostatectomy.

Purpose: To analyze routine preoperative prostate MRI to predict erectile function (EF) before and after radical prostatectomy (RP).

Methods: Patients who underwent RP with an existing preoperative MRI including dynamic contrast-enhanced images and completed International Index of Erectile Function (IIEF-5) questionnaires at baseline and 12 months postoperative. They were divided into four erectile dysfunction (ED) groups according to preoperative IIEF-5 score.

Comparison of the PI-RADS 2.1 scoring system to PI-RADS 2.0: Impact on diagnostic accuracy and inter-reader agreement.

Purpose: To assess the value of the PI-RADS 2.1 scoring system in the detection of prostate cancer on multiparametric MRI in comparison to the standard PI-RADS 2.0 system and to assess its inter-reader variability.

Magnetic resonance imaging of the prostate after focal therapy with high-intensity focused ultrasound.

For clinically significant, locally confined prostate cancer, whole-gland radical prostatectomy and radiotherapy are established effective treatment strategies that, however, come at a cost of significant morbidity related to urinary and sexual side effects. The concept of risk stratification paired with a better understanding of prognostic factors has led to the development of alternative management options including active surveillance and focal therapy for appropriately selected patients with localized disease. High-intensity focused ultrasound (HIFU) is one such minimally invasive, image-guided treatment option for prostate cancer.

Manual prostate cancer segmentation in MRI: interreader agreement and volumetric correlation with transperineal template core needle biopsy.

Objectives: To assess interreader agreement of manual prostate cancer lesion segmentation on multiparametric MR images (mpMRI). The secondary aim was to compare tumor volume estimates between MRI segmentation and transperineal template saturation core needle biopsy (TTSB).

Methods: We retrospectively reviewed patients who had undergone mpMRI of the prostate at our institution and who had received TTSB within 190 days of the examination.

Variability of manual segmentation of the prostate in axial T2-weighted MRI: A multi-reader study.

Purpose: To evaluate the interreader variability in prostate and seminal vesicle (SV) segmentation on T2w MRI.

Methods: Six readers segmented the peripheral zone (PZ), transitional zone (TZ) and SV slice-wise on axial T2w prostate MRI examinations of n = 80 patients. Twenty different similarity scores, including dice score (DS), Hausdorff distance (HD) and volumetric similarity coefficient (VS), were computed with the VISCERAL EvaluateSegmentation software for all structures combined and separately for the whole gland (WG = PZ + TZ), TZ and SV.

External Validation and Comparison of Prostate Cancer Risk Calculators Incorporating Multiparametric Magnetic Resonance Imaging for Prediction of Clinically Significant Prostate Cancer.

Purpose: We sought to externally validate recently published prostate cancer risk calculators incorporating multiparametric magnetic resonance imaging to predict clinically significant prostate cancer. We also compared the performance of these calculators to that of multiparametric magnetic resonance imaging naïve prostate cancer risk calculators.

Materials And Methods: We identified men without a previous prostate cancer diagnosis who underwent transperineal template saturation prostate biopsy with fusion guided targeted biopsy between November 2014 and March 2018 at our academic tertiary referral center.

Comparison of PSA-density of the transition zone and whole gland for risk stratification of men with suspected prostate cancer: A retrospective MRI-cohort study.

Purpose: To compare the correlation of transition zone prostate-specific antigen density (TZPSAD) versus whole gland (WG) density (PSAD) with Gleason score.

Methods: In this single-center, retrospective cohort study, men undergoing MRI of the prostate in 2015 and 2016 who had a transperineal template saturation biopsy within 6 months of MRI were included (n = 178; median age 64 y, interquartile range [IQR] 58-68 y; PSA 6.6 ng/ml, 4.

Diagnostic Accuracy of Multiparametric MRI versus Ga-PSMA-11 PET/MRI for Extracapsular Extension and Seminal Vesicle Invasion in Patients with Prostate Cancer.

Background Recent studies have reported the additive value of combined gallium 68 (Ga)-labeled Glu-urea-Lys (Ahx)-HBED-CC ligand targeting the prostate-specific membrane antigen (PSMA) (hereafter called Ga-PSMA-11) PET/MRI for the detection and localization of primary prostate cancer compared with multiparametric MRI. Purpose To compare the diagnostic accuracy and interrater agreement of multiparametric MRI and Ga-PSMA-11 PET/MRI for the detection of extracapsular extension (ECE) and seminal vesicle infiltration (SVI) in patients with prostate cancer. Materials and Methods Retrospective analysis of 40 consecutive men who underwent multiparametric MRI and Ga-PSMA-11 PET/MRI within 6 months for suspected prostate cancer followed by radical prostatectomy between April 2016 and July 2018.