What Method Is Best for Detecting Prostate Cancer Metastases?

November 19, 2018

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-weighted1 min. 25 sec.88.3% (68/77)62.3% (48/77)
Turbo inversion recovery magnitude15 min. 7 sec.94.8% (73/77)88.3% (68/77)
WB DWI16 min. 33 sec.95.2% (40/42)90.5% (38/42)
Gadolinium-enhanced T1-weighted VIBE1 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.