Dr. Hedvig Hricak: Prostate MRI

Dr. Hedvig HricakDr. Hedvig Hricak is the Chair of the Department of Radiology at Memorial Sloan Kettering Cancer Center. She received the 2014 American Urological Association Presidential Citation for her pioneering work in prostate MRI.

Hricak has been involved in MRI research since the field emerged in the early 1980s. She has published over 380 peer-reviewed original research articles and more than 300 review articles, editorials, and book chapters, as well as 18 books.

Prostate Forum recently spoke with her about MRI for prostate cancer. To read the rest of our conversation with Dr. Hricak when it is released next week, subscribe to Prostate Forum.

PROSTATE FORUM: Patients are often confused by the different terms they run across in web searches-MRI versus Multi-parametric MRI versus 3T MRI. What is multi-parametric MRI?

DR. HRICAK: Multiparametric MRI (MP-MRI) refers to the use of multiple MRI sequences; T1- and T2-weighted sequences are the backbone of MRI. MP-MRI occurs when you add at least one more sequence that will offer information beyond anatomy, such as diffusion-weighted imaging, dynamic contrast-enhanced imaging, or MR spectroscopic imaging. 3T MRI refers to MRI performed at the specific field strength of 3 Tesla. Today, most prostate imaging is performed on either a 1.5-Tesla or a 3-Tesla machine.

PROSTATE FORUM: Can MRI be used to more precisely target biopsies, radiation treatment and surgery? Can it more precisely detect lymph node metastasis?

HRICAK: Yes, it can be used to more precisely target biopsies. It can also allow better planning of radiation treatment or the surgical approach. However, the evaluation of lymph nodes by MRI is still based only on anatomical imaging and is not very precise. Further development needs to be done in that area.

PROSTATE FORUM: How does MRI compare with other imaging techniques like Carbon-11 Choline PET/CT or Carbon-11 Acetate PET/CT?

HRICAK: There is now greater consensus in this area, with broad acceptance of the notion that MRI is the modality of choice for detection and staging of primary disease, while nuclear medicine tracers are used for detection of recurrence or, when indicated, for evaluation of lymph node and bone metastasis.

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