Multiparametric Magnetic Resonance Imaging for the Detection of Clinically Significant Prostate Cancer: What Urologists Need to Know. Part 1: Acquisition

BACKGROUND: Acquiring multiparametric magnetic resonance images of the prostate is not a simple "push-button" approach. OBJECTIVE: To show how image acquisition of prostate multiparametric Magnetic Resonance Imaging (mpMRI) can be optimized. DESIGN, SETTING, AND PARTICIPANTS: Image protocols, magnetic field strength choice, and the use of receiver coils are discussed. In addition, patient preparation and the recognition, prevention, and mitigation of artifacts are evaluated. SURGICAL PROCEDURE: Based on expert prostate MRI technologists (MRI radiographers) opinion, the optimal protocol is reviewed, and potential artifacts are determined. MEASUREMENTS: The entire acquisition process is presented from initial patient preparation until the end of the imaging. The choice of the used equipment, pulse sequences, and prevention of patient- and imaging-related artifacts are presented. This will be shown in individual patients. RESULTS AND LIMITATIONS: Although the Prostate Imaging Reporting and Data System guidelines (2012 and 2016) describe minimal and optimal acquisition protocols for prostate mpMRI, these standards are not always met in daily practice. A major challenge in mpMRI is to obtain high image quality and reduce its variability for radiologic interpretations. A summary of evidence and guidelines for the acquisition of mpMRI of the prostate can set a basic guideline to reduce these variabilities. CONCLUSIONS: This article and an accompanying video can be used as a guide by MRI technologists (MRI radiographers) to improve their image acquisitions by optimizing protocols, magnetic field strength choice, and use of receiver coils. We also discuss patient preparation and the recognition, prevention, and mitigation of artifacts. PATIENT SUMMARY: In this first surgery-in-motion contribution, we will show how optimized image acquisition is performed to detect prostate cancer. Both MRI-dependent and patient related factors are discussed.