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Image Acquisition: DCE

2 min.
Pomeranz, Stephen
Stephen J Pomeranz, MD
Chief Medical Officer, ProScan Imaging. Founder, MRI Online
CME Eligible

Some clarifications regarding dynamic contrast enhanced or DCEMRI. Typically, if you're doing bi-parametric MRI, all you're using is T2 and diffusion weighted imaging, so you're not injecting at all. So this would be bi-parametric prostate MRI. On the other hand, if you add in DC MRI or some other potential parameters, but let's just stick with DC MRI right now, then it becomes multiparametric. So multiparametric prostate MRI, and you're going to see abbreviations like this all over the place. That's why I'm clarifying for you. You put an IV in the patient, 16 or 18 gauge in the antecubital fossa and I'd like to see you injected four cc's per second. So you have to have a pretty good hose in the arm to make this injection rate. Then the temporal resolution, you're going to acquire at each locus in the prostate. So here's one up at the base.

Here's another one at the mid. Here's another one at the apex. At each stop, you're going to have a series of images at zero and maybe seven seconds and maybe 14 seconds and maybe 21 seconds. So every seven seconds you got an image. But according to the PI-RADS 2.1, it should never be more than 15 seconds. So it can be zero, 15, 30, 45, but it cannot be zero, 30, 60, and so on. That would be too long a time delay. So we've set some criteria, I personally use between seven and 12 seconds, depending upon the performance of my magnet. Higher end magnets with stronger gradients can get tighter windows zero, seven, 14, 21, 28. Some of the older magnets can still do a perfectly fine prostate MRI, but you have zero, 15, 30, and 45 is the outside range in terms of temporal resolution. I want you to make this acquisition using 3D T1 gradient echo imaging, which goes by many names from many vendors. Dr. P out.

LESSON 2, TOPIC 9

Mastery Series: PI-RADS 2.1 Update

Mastery Series

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Content reviewed: December 29, 2021

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