Well-planned patient preparation before their scans improves imaging quality and cancer detection rates

An NIHR Cambridge BRC-supported review of existing studies has found that adequate preparation of patients with suspected prostate cancer before their MRI scans could significantly improve imaging quality, cancer detection rates and subsequent treatment planning.

Multiparametric magnetic resonance imaging (mpMRI) is a special type of scan that creates more detailed pictures of the prostate. It plays an essential role in the diagnosis of prostate cancer (PCa), and can help doctors decide if tumours are clinically significant (that is, likely to impact on a patient’s life and therefore needing treatment); it is now performed in up to 75% of men with suspicion of PCa in the UK.

Existing guidelines on its use, while they address technical hardware and software and diagnostic considerations, have not to date adequately covered patient-related factors which also can affect the quality of the imaging.

This review from Cambridge radiologists Dr Tristan Barrett and Dr Iztok Caglič looked at how some simple steps can help to further optimise the image quality of mpMRI.

Before mpMRI the authors therefore recommend:

  • Using antiperistaltic agents to minimise spasm in the intestines and associated movement (which can result in blurring of image)
  • Asking patients to empty their bowels prior to examination to minimise image distortion
  • Asking patients to refrain from ejaculation for three days before their scans
  • Using an additional scan sequence called PROPELLER to improve image quality in patients with hip metalwork.

Read the full article: https://doi.org/10.1016/j.crad.2018.12.003

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