Multiparametric MRI of Prostate Cancer: Recent Advances

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GERIATRICS (G GUGLIEMI, SECTION EDITOR)

Multiparametric MRI of Prostate Cancer: Recent Advances Elena Ventrella1 • Laura Eusebi2 • Francesca Anna Carpagnano3 Francesco Bartelli2 • Luigi Cormio4,5 • Giuseppe Guglielmi1,3,6



 Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract Purpose of Review To bring the radiologists up to date on the state of the art of the magnetic resonance imaging in detection of prostate cancer and on the findings to consider for reports. Recent Findings Recently, the members of American College of Radiologist updated the new guidelines (Prostate Imaging—Reporting and Data System) with new recommendations on the acquisition and reporting of MRI for staging and restaging of prostate cancer, giving a particular importance to the latest advanced MRI techniques (diffusion-weighted imaging and dynamic contrast-enhanced imaging). Summary Magnetic resonance imaging plays a fundamental role in prostate cancer staging and restaging; moreover, it allows the detection of some findings with prognostic value. This review includes the last American This article is part of the Topical Collection on Geriatrics. & Giuseppe Guglielmi [email protected]; http://www.unifg.it 1

Department of Radiology, ‘‘Dimiccoli’’ Hospital, Barletta, Italy

2

Radiologia Ospedale ‘‘Carlo Urbani’’, Jesi, Italy

3

Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71121 Foggia, Italy

4

Department of Urology and Renal Transplantation, Foggia University School Medicine, Foggia, Italy

5

Department of Urology, Bonomo Teaching Hospital, Andria, BT, Italy

6

Department of Radiology, Hospital ‘‘Casa Sollievo Della Sofferenza’’, San Giovanni Rotondo, Foggia, Italy

College of Radiologist updated Recommendations on magnetic resonance imaging protocol, interpretation, and reporting. Keywords Prostate cancer  mp-MRI  DWI  DCE

Epidemiology and Etiopathogenesis of Prostate Cancer Prostate cancer (PCa) is the most common non-cutaneous cancer type and the second cause of death in male subjects [1]. The incidence of clinical diagnosed PCa is widely variable and it is higher in Northern and Western Europe ([ 200 every 100,000 man/year) [2]. Nowadays, PCa is the most frequent neoplasm between males and it represents more than 20% of all tumors diagnosed over 50 years old [3]. PCa has obviously a multifactorial pathogenesis, resulting from a complex interaction between genetic factors (related to familiarity and to different incidence among races) and environmental factors (diet and environmental carcinogens). Largely known risk factors are the age (the incidence rises with elderly), the race (Afro-Americans have an increased risk because of their higher circulating levels of androgens, DHT, and 5-alpha-reductase) [4], hormonal factors (high circulating levels of testosterone and IGF-1 seem to predispose to PCa), familial history of PCa (around 25% of patients)/genetic factors (9% hereditary forms; 43