0:00

Let's talk about DCE, Dynamic Contrast

0:04

Enhanced MRI, where you're injecting

0:06

20cc's of gadolinium and looking at the

0:09

arrival of contrast in the prostate.

0:12

In a negative, there is no early enhancement.

0:16

Or, there is diffuse, generalized,

0:19

symmetric enhancement that doesn't

0:21

correspond to a focal, worrisome, or

0:24

suspicious finding on T2, DWI, or the ADC map.

0:30

If there is some focal

0:31

enhancement, it is not early.

0:33

And it corresponds to an area that

0:35

looks like a BPH nodule or a benign,

0:39

non-aggressive area on T2 imaging.

0:42

A positive focal early enhancement,

0:45

often corresponding to arterial arrival

0:49

in the neighboring vascular tissues.

0:52

That enhancement occurs before any other

0:55

portions of the prostate gland that

0:57

are not suspicious and corresponds to

1:01

areas that are worrisome on T2 imaging.

1:04

VASP and echo MRI, such as a lentiform

1:07

charcoal-like area in the TZ or a round

1:11

nodular area with mass effect in the PZ.

1:14

And that area often corresponds to a focus of

1:17

diffusion-weighted restriction, high signal with

1:21

a high B value, and low intensity on the ADC map.

1:25

Either a negative or a positive for DCE MRI, which

1:29

by the way, plays a lesser role in the prostate,

1:32

than it does in detection

1:34

of malignancy in the breast.

PI-RADS Assessment for DCE

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0:00

Let's talk about DCE, Dynamic Contrast

0:04

Enhanced MRI, where you're injecting

0:06

20cc's of gadolinium and looking at the

0:09

arrival of contrast in the prostate.

0:12

In a negative, there is no early enhancement.

0:16

Or, there is diffuse, generalized,

0:19

symmetric enhancement that doesn't

0:21

correspond to a focal, worrisome, or

0:24

suspicious finding on T2, DWI, or the ADC map.

0:30

If there is some focal

0:31

enhancement, it is not early.

0:33

And it corresponds to an area that

0:35

looks like a BPH nodule or a benign,

0:39

non-aggressive area on T2 imaging.

0:42

A positive focal early enhancement,

0:45

often corresponding to arterial arrival

0:49

in the neighboring vascular tissues.

0:52

That enhancement occurs before any other

0:55

portions of the prostate gland that

0:57

are not suspicious and corresponds to

1:01

areas that are worrisome on T2 imaging.

1:04

VASP and echo MRI, such as a lentiform

1:07

charcoal-like area in the TZ or a round

1:11

nodular area with mass effect in the PZ.

1:14

And that area often corresponds to a focus of

1:17

diffusion-weighted restriction, high signal with

1:21

a high B value, and low intensity on the ADC map.

1:25

Either a negative or a positive for DCE MRI, which

1:29

by the way, plays a lesser role in the prostate,

1:32

than it does in detection

1:34

of malignancy in the breast.

Report

Faculty

Stephen J Pomeranz, MD

Chief Medical Officer, ProScan Imaging. Founder, MRI Online

ProScan Imaging

Lesson

MRI Mastery Series: Prostate Pre-Course Activities

Lesson

Introduction

Lesson

Prostate Anatomy

Lesson

Prostate Assessment & Scoring

Lesson

Evaluating BPH

Lesson

Case Review

PI-RADS Assessment for DCE