NL
DE
A recent international study suggests that a non-contrast MRI protocol could effectively diagnose prostate cancer, potentially transforming diagnostic procedures by reducing the need for contrast agents.
Magnetic resonance imaging (MRI) has become essential in diagnosing prostate cancer, and typically involves a scan were a contrast agent is administered. However, a recent international reader study suggests that a simplified, non-contrast MRI protocol may be similarly effective in diagnosing prostate cancer, offering a more streamlined alternative to the traditional approach.
Jasper Twilt and colleagues conducted a large international reader study comparing the diagnostic effectiveness of both MRI approaches to determine whether a non-contrast MRI protocol is not significantly less effective in identifying prostate cancer. Led by Jurgen Fütterer, Henkjan Huisman, and Maarten de Rooij from the Department of Medical Imaging in Radboudumc, the research was conducted in collaboration with the PI-CAI community, a global consortium of medical and scientific experts in the field of prostate cancer and AI. The study was published online in European Urology on October 22.
The team designed an international reader study that involved 62 radiologists from twenty countries. 400 prostate MRI scans from four different centers in Europe were analyzed for the presence of clinically significant prostate cancer. Each MRI examination was first evaluated with the non-contrast protocol, followed by a review that included the contrast scan. The findings showed that the non-contrast protocol and the standard protocol yielded almost identical results for detecting clinically significant prostate cancer, confirming that the simpler protocol was not significantly less effective.
Reducing the need for a contrast scan could simplify and shorten MRI procedures, lessening the burden on radiology departments and make prostate MRI more convenient and accessible for patients. However, the researchers emphasize that further prospective studies are needed to confirm these findings in clinical settings. The current study, for example, excluded patients with prior prostate cancer findings or treatments and involved radiologists working in a research reading environment instead of their regular clinical routine. Future prospective studies will explore the effectiveness of the non-contrast protocol in a broader and more diverse patient group to better understand its potential in routine clinical practice.
This research is part of Radboudumc Research program: Prostate, bladder and kidney cancer
About the publication
J. J. Twilt, A. Saha, J. S. Bosma, B. van Ginneken, A. Bjartell, A. R. Padhani, D. Bonekamp, G. Villeirs, G. Salomon, G. Giannarini, J. Kalpathy-Cramer, J. Barentsz, K. H. Maier-Hein, M. Rusu, O. Rouvière, R. van den Bergh, V. Panebianco, V. Kasivisvanathan, N. A. Obuchowski, D. Yakar, M. Elschot, J. Veltman, J. J. Fütterer, H. Huisman, M. de Rooij and the PI-CAI consortium. Evaluating Biparametric Versus Multiparametric Magnetic Resonance Imaging for Diagnosing Clinically Significant Prostate Cancer: An International, Paired, Noninferiority, Confirmatory Observer Study. European Urology. 2024;0(0). doi:10.1016/j.eururo.2024.09.035
