We have recently started to see a flurry of publications of papers suggesting that biparametric MRI (bpMRI) scans may be “better” — or at least more cost-effective — than multiparametric MRI (mpMRI) scans in the diagnosis of localized forms of prostate cancer.
Your sitemaster wishes to be very clear that he does not pretend to be an expert on the subtleties of the differences between these two types of MRI scanning. However, the primary differences appear to be these:
- bpMRIs can be carried out much faster than mpMRIs (more like 15 minutes as opposed to 45 minutes).
- bpMRIs can be carried out without the use of contrast media (which can present a problem for a small subset of patients).
- bpMRIs are therefore more cost-effective than mpMRIs.
Like mpMRI scans, bpMRI scans can be carried out using MRI field strengths of 1.5 T and 3.0 T, and the latter is probably to be preferred.
Having said that, it still seems likely that mpMRI scans may be a better idea for men suspected of being of higher risk while bpMRIs could become more common among men thought to have very low- or low-risk forms of prostate cancer.
We are likely to have more to say about this as the use of MRI scanning continues to evolve in the diagnosis and management of localized and locally advanced forms of prostate cancer. However, for the time being, here are some links to papers that can help interested readers to learn more for themselves:
- Scialpi M, et al. Biparametric MRI of the prostate. Turk J Urol. 2017; 43:401–409
- Thestrup KCD, et al. Biparametric versus multiparametric MRI in the diagnosis of prostate cancer. Acta Radiol Open. 2016; 5: PMC4990814
- Cuocolo R, et al. PSA-density does not improve bi-parametric prostate MR detection of prostate cancer in a biopsy naïve patient population. Eur J Radiol. 2018; 104:64-70
- Boesen L, et al. Assessment of the diagnostic accuracy of biparametric magnetic resonance imaging for prostate cancer in biopsy-naive men: the biparametric MRI for detection of prostate cancer (BIDOC) study.
Readers are reminded that whether one has an mpMRI scan or a bpMRI scan, the skills of the individuals who (a) carry out the scan and (b) interpret the scan data remain crucial factors in determining the value of any particular scan.
Filed under: Diagnosis, Management, Risk | Tagged: biparametric, bpMRI, mpMRI, MRI, multiparametric, scan |
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