New prospective research demonstrates enhanced imaging quality and bolstered diagnostic assessments with 5T magnetic resonance imaging (MRI) in comparison to 3T MRI in the detection of prostate cancer (PCa).
For the study, recently published in Prostate Cancer and Prostatic Diseases, researchers reviewed data from 67 patients who had 5T and 3T prostate MRI exams. The median prostate-specific antigen level of the cohort was 9.52 ng/ml, according to the study. The study authors noted that 47 patients had prostate cancer (PCa) and 39 patients had clinically significant prostate cancer (csPCa).
With 5T MRI, the researchers found an 11.8 percent higher percentage of PCa detection in patients with PI-RADS 4 and 5 cases in comparison to 3T MRI (97.8 percent vs. 86 percent). For patients with PI-RADS 2 presentations, the study authors noted that 5T MRI offered a 25 percent higher detection of benign cases (100 percent to 75 percent).
Lesion apparent diffusion coefficient (ADC) values with 5T MRI yielded an 88.7 percent AUC for predicting PCa and an 84.3 percent AUC for predicting csPCa, according to the study authors. Employing an ADC cutoff threshold < 600 X 10-3 mm2/s, the researchers pointed out that 5T MRI accurately predicted 100 percent of PCa cases and 89.47 percent of csPCa.
“Despite the limited sample size, which precluded full statistical analysis, the available data already reveal a promising trend, suggesting that 5 T MRI holds great potential for the diagnosis and treatment planning of PCa,” noted lead study author Tianyu Xiong, M.D., who is affiliated with the Department of Urology at Beijing Friendship Hospital and Capital Medical University in Beijing, China, and colleagues.
The study authors noted a greater than 47 percent higher overall image quality score for 5T MRI in contrast to 3T MRI (74.6 percent vs. 26.9 percent). The researchers also found that excellent or good delineation was achieved for T2-weighted imaging (T2WI) in 83.6 percent of cases and diffusion-weighted imaging (DWI) in 82.3 percent of cases for 5T MRI in comparison to 28.4 percent and 55.2 percent, respectively, for 3T MRI.
Three Key Takeaways
- Improved cancer detection and characterization. 5T prostate MRI demonstrated higher PCa detection in PI-RADS 4–5 lesions compared with 3T MRI (97.8 percent vs. 86 percent) and more accurate identification of benign findings in PI-RADS 2 cases, supporting better risk stratification and biopsy decision-making.
- Strong quantitative performance with ADC metrics. Lesion ADC values at 5T showed high diagnostic accuracy (AUC 0.89 for PCa; 0.84 for csPCa), with an ADC cutoff <600 × 10⁻³ mm²/s correctly identifying all PCa cases and nearly 90 percent of csPCa, highlighting the potential of diffusion metrics for noninvasive prediction.
- Superior image quality with workflow advantages. 5T MRI achieved markedly better T2WI and DWI image quality and lesion delineation than 3T, while potentially eliminating contrast use and shortening scan time — features that may enhance efficiency, patient tolerance, and enable AI-assisted analysis and screening applications.
“ … The image quality at 5T was significantly improved for both T2WI and DWI sequences. These results alleviate the major concern that a higher field strength might increase artifacts,” pointed out Xiong and colleagues.
The researchers also pointed out that 5T prostate MRI offers other practical advantages over 3T MRI.
“Compared with 3T, 5T MRI avoids the need for contrast injection and dynamic sequences, thereby reducing patient burden and increasing the efficiency of prostate scanning. With the assistance of deep-learning reconstruction software, 5T MRI could minimize scan times and be adopted for PCa screening. The superior clarity of 5T MRI also provides a favorable imaging foundation for artificial-intelligence-based image analysis,” added Xiong and colleagues.
(Editor’s note: For related content, see “Can an Integrated Approach with PSMA PET/CT and Prostate MRI Enhance Detection of Extraprostatic Extension?,” “Should PSMA PET/CT Supplant MRI For Staging of Patients with High-Risk PCa?” and “Top Five Prostate Cancer Imaging Content in 2025.”)
Citing the inherent limitations of a single-center study and an analysis of EPE and SVI limited to a small number of patients who had a radical prostatectomy, the researchers acknowledged that larger studies are necessary for validations of their research findings.
