Future Developments

Recent developments in MR imaging include contrast-enhanced fast dynamic MR imaging, magnetic resonance spectroscopy (MRS), the use of nano-particles and 3T.

Fast Dynamic Imaging

Cancer can be differentiated from normal tissue by fast dynamic contrast-enhanced MR imaging because of typical tumour enhancement characteristics. On contrast-enhanced MR imaging, prostate cancer shows a typical early and rapid enhancement with a higher peak enhancement and wash-out of contrast compared to normal tissues [38-39]. This can be used to improve tumour localisation detection (Fig. 5). Also, when one knows where the tumour is locat-

Fig. 5. Patient with previous negative biopsies. a Axial T2-weighted image shows low SI region in central gland, but not specific for tumor. b Wash-out image, same slice level as a shows wash-out of contrast in the central gland. Biopsy directed to this area was positive and stage T2B prostate cancer was confirmed at prostatectomy (c) within lined area

ed, staging results will improve. This has been shown to be especially valuable for inexperienced readers [40]. Other fields where dynamic MR imaging may have a potential role are therapy monitoring and the prediction of therapy success of systemic therapy of prostate cancer [41]. Current problems of detection with dynamic MR imaging of prostate carcinoma involve the large variation in enhancement patterns among patients with prostate carcinoma and the overlapping enhancement pattern of BPH, pro-static intraepithelial hyperplasia (PIN) and inflammation. However, using fast sequences and quantitative or semiquantitative parameters, like wash-out of the contrast agent in cancer, makes differentiation from BPH possible [42].

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