Expert discusses use prostate MRI with and without contrast

Opinion
Video

"There are situations where you can use a biparametric or noncontrast approach; most of them you will prefer still to use an approach with contrast," says Leonardo Kayat Bittencourt, MD, PhD.

In this video, Leonardo Kayat Bittencourt, MD, PhD, discusses mpMRI of the prostate. Bittencourt is vice chair of innovation in the department of radiology at UH Cleveland Medical Center, a radiologist in abdominal imaging at UH Cleveland Medical Center, associate professor of radiology at Case Western Reserve University, School of Medicine, and a member of the Cancer Imaging Program at Case Comprehensive Cancer Center in Cleveland, Ohio.

Transcription:

What are the advantages of multiparametric MRI of the prostate?

That's a good question, and I think it also asks for a minor clarification. There was a rather recent position paper from the PI-RADS committee on the use of MRI with and without contrast, and that paper addresses the issue of biparametric, multiparametric MRI, and so on. It has been commonly adopted as the definition that multiparametric MRI is the complete exam containing T2 weighted imaging, diffusion weighted imaging, and dynamic contrast enhancement assessment. Whereas biparametric has been termed as the reduced or simplified exam without contrast, containing only T2 weighted imaging and diffusion weighted imaging. But then, if you would check on this reference by the PI-RADS committee, it was preferred to adopt a slightly different terminology that all of those exams are preferred to be referred as prostate MRI in general, and you differentiate them by prostate MRI with contrast and prostate MRI without contrast. The reasons are multiple, usually revolving around coding and billing because it's easier to communicate by using a more standardized language. It is also easier for the patients to understand, and it highlights that the difference between those 2 approaches would be the use of contrast or not. You [don't] want a situation where people think that the biparametric exam is a worse exam, because it is not. There are situations where you can use a biparametric or noncontrast approach; most of them you will prefer still to use an approach with contrast. I think that summarizes a little bit of the discussion of what is a multiparametric MRI.

This transcription was edited for clarity.

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