Dynamic contrast enhancement in prostate cancer
Dynamic contrast enhancement (DCE) MRI is emerging as a useful clinical technique as part of a multiparametric approach for evaluating the extent of primary and recurrent prostate cancer.
Protocol and equipment
Typically 3D T1-weighted fast spoiled gradient-echo MRI sequences with an endorectal coil are used to repeatedly image a volume of interest after the administration of a bolus of intravenous contrast agent (gadolinium).
Image sets are obtained sequentially every few seconds for up to 5-10 minutes. Ideally, acquisitions should be obtained approximately every 5 seconds to allow the detection of early enhancement 1.
- spatial resolution is often lower than conventional T2-weighted sequences
- there may be a variation in sensitivity according to zonal anatomy 3
A type III wash-out curve (time intensity curve): early faster enhancement followed by decreasing enhancement over time, is a concerning feature.
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- 2. Fütterer JJ, Heijmink SW, Scheenen TW et-al. Prostate cancer localization with dynamic contrast-enhanced MR imaging and proton MR spectroscopic imaging. Radiology. 2006;241 (2): 449-58. doi:10.1148/radiol.2412051866 - Pubmed citation
- 3. Sung YS, Kwon HJ, Park BW et-al. Prostate cancer detection on dynamic contrast-enhanced MRI: computer-aided diagnosis versus single perfusion parameter maps. AJR Am J Roentgenol. 2011;197 (5): 1122-9. doi:10.2214/AJR.10.6062 - Pubmed citation
- 4. Ocak I, Bernardo M, Metzger G et-al. Dynamic contrast-enhanced MRI of prostate cancer at 3 T: a study of pharmacokinetic parameters. AJR Am J Roentgenol. 2007;189 (4): 849. doi:10.2214/AJR.06.1329 - Pubmed citation
- 5. Choi YJ, Kim JK, Kim N et-al. Functional MR imaging of prostate cancer. Radiographics. 2007;27 (1): 63-75. doi:10.1148/rg.271065078 - Pubmed citation
- 6. Jackson AS, Reinsberg SA, Sohaib SA et-al. Dynamic contrast-enhanced MRI for prostate cancer localization. Br J Radiol. 2009;82 (974): 148-56. doi:10.1259/bjr/89518905 - Pubmed citation
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