Non-contrast Prostate MR Imaging (versus IV Contrast Enhancement MRI)

Non-contrast Prostate MR Imaging (versus IV Contrast Enhanced MRI)

Is a non-invasive, less costly study for the patient, with less time in the magnet (potentially removing real or perceived barriers for patients).

Is American College of Radiology (ACR) “appropriate” by ACR guidelines.

Does not compromise PI-RADS scoring or potential fusion biopsy targeting (only peripheral zone grade 3 lesions might be upgraded to 4 by contrast enhancement, focal lesion targeting is based on other MR sequences).

Allows for more flexible MR scheduling and increased patient throughput. There are about 182,000 men in the state of Delaware between the ages of 40 and 70 (2020 census data). There are only 5 3T MRI centers in the state that do prostate MR imaging.

Radiologist groups throughout the state have been contacted and do not have strong objections to non-contrast studies (Bayhealth, Beebe, Christiana, Peninsula Imaging, and RadNet).

There is published literature to support the use of non-contrast studies for both initial biopsy virgin and subsequent active surveillance exams;

Asbach P. European Radiology 2023;33:8413-8414

Sanmugalingam N. American Journal of Roentgenology AJR 2023;221:649-660

Information above researched by Michael Mulligan, MD (retired Professor of Radiology, University of Maryland School of Medicine, member Board of Directors for Delaware Prostate Cancer Coalition)