MRI First: The Role of MRI in Biopsy Naïve Patients

Monju J. Patel, MD, discusses how variation in mpMRI image quality and radiologist interpretation and experience, as well as technicalities of the PIRADS-2 scoring system, can significantly impact radiologists’ ability to detect lesions suspicious for prostate cancer. He goes on to present several case studies on how to utilize mpMRI’s strong specificity to evaluate extraprostatic extension and anterior transition zone tumors, and how to use mpMRI to evaluate the entire pelvis for possible metastatic disease. Finally, Dr. Patel considers the detection pitfalls of mpMRI, such as differentiating benign anatomy versus a malignancy, abnormalities that exist in the central zone, and how to identify diffuse, infiltrative carcinoma.

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