Characterization of Clinically Significant Prostate Cancer in the Peripheral Zone Using Rapid B 1 -Insensitive MR Fingerprinting.
Adding PSA density to MRI fingerprinting and diffusion imaging best identified clinically significant prostate cancer
Characterization of Clinically Significant Prostate Cancer in the Peripheral Zone Using Rapid B 1 -Insensitive MR Fingerprinting.
MR fingerprinting (MR fingerprinting) has shown utility in focal prostate lesion characterization as a complement to standard prostate MRI.
To determine the utility of a rapid, B 1 -insensitive MR fingerprinting technique, combined with standard diffusion MRI, in the characterization of focal prostate lesions in the peripheral zone (peripheral zone), with MRI-guided transrectal US fusion biopsy-derived histopathologic analysis as the reference standard.
Between February 2021 and April 2024, consecutive adults with clinical suspicion of prostate cancer (prostate cancer) who had not undergone biopsy underwent MRI, including rapid, B 1 -insensitive MR fingerprinting (15 seconds per section) on a 3.0-T MRI unit.
adding prostate-specific antigen density to MRI raised accuracy for distinguishing dangerous from harmless cancers, near perfect
The mean T2 and apparent diffusion coefficient were lower for csPCa ( n = 22) than for clinically insignificant lesions ( n = 29) (T2, 56 msec ± 12 vs 80 msec ± 20, respectively [ P < .001]; apparent diffusion coefficient, 668 × 10 -6 mm 2 /sec ± 111 vs 876 × 10 -6 mm 2 /sec ± 181, respectively [ P < .001]).
At univariable analyses, an optimal T2 cutoff of 58 msec yielded an AUC of 0.87 (95% CI: 0.76, 0.97) (sensitivity, 73% [16 of 22]; specificity, 93% [27 of 29]), whereas an apparent diffusion coefficient cutoff of 761 × 10 -6 mm 2 /sec yielded an AUC of 0.83 (95% CI: 0.71, 0.95) (sensitivity, 82% [18 of 22]; specificity, 79% [23 of 29]).
Rapid, B 1 -insensitive prostate MR fingerprinting-derived T1 and T2 combined with apparent diffusion coefficient and serum prostate-specific antigen density improved prostate cancer characterization in the peripheral zone.
© RSNA, 2026 Supplemental material is available for this article. See also the editorial by Margolis and Gulani in this issue.