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What Method Is Best for Detecting Prostate Cancer Metastases?
Diagnostic Imaging Staff
The imaging process provides the most time-efficient sequence with the highest lesion detection rate and conspicuity.
Gadolinium-enhanced T1-weighted volumetric interpolated breath-hold exam (VIBE) is best for detecting prostate cancer metastases, according to a study published in the American Journal of Roentgenology.
Researchers from Canada performed a prospective study to compare the diagnostic value of various MRI sequences used for whole-body (WB) 18F-fluorocholine (FCH) PET/MRI staging of patients with high-risk prostate cancer. The study included 58 patients with untreated high-risk prostate cancer. Ten patients underwent integrated WB FCH PET/MRI; 48 underwent FCH PET/CT and WB MRI. The researchers recorded metastatic sites and used histopathologic findings or clinical and imaging follow-up (or both) for standard of reference.
The results showed the gadolinium-enhanced T1-weighted volumetric interpolated breath-hold exam (VIBE) was the best of the four sequences:
| Dixon T1-weighted | 1 min. 25 sec. | 88.3% (68/77) | 62.3% (48/77) |
| Turbo inversion recovery magnitude | 15 min. 7 sec. | 94.8% (73/77) | 88.3% (68/77) |
| WB DWI | 16 min. 33 sec. | 95.2% (40/42) | 90.5% (38/42) |
| Gadolinium-enhanced T1-weighted VIBE | 1 min. 28 sec. | 97.4% (75/77) | 92.2% (71/77) |
Conspicuity of metastases on gadolinium-enhanced T1-weighted VIBE and WB DWI sequences was higher than that on Dixon T1-weighted sequences.
The researchers concluded that metastases from prostate cancer are best detected at DWI or gadolinium-enhanced T1-weighted VIBE sequences. The most time-efficient sequence with the highest lesion detection rate and conspicuity is gadolinium-enhanced T1-weighted VIBE.