Zusammenfassung
Die Magnetresonanztomografie (MRT) der Prostata wird als multiparametrische MRT (mpMRT, auch MR-Prostatografie) standardisiert durchgeführt. Dafür sind technische Kriterien hinsichtlich Feldstärke, Sequenzen und Qualitätsrichtlinen sowie ein einheitliches Schema zur Befundübermittlung durch den Radiologen definiert. Die Prostate MRI Working Group der amerikanischen und europäischen Fachgesellschaften ACR und ESUR gibt dazu regelmäßig Empfehlungen für technische Qualitätsanforderungen sowie die Anwendung eines Befundungs- und Reportingschemas (PI-RADS) heraus. Der jeweilige PI-RADS Score (1–5) ist bestimmend für die Biopsieindikation. Die korrekte Dokumentation der Befundlokalisation in einem dafür vorgegebenen grafischen Schema der Prostata dient dabei als Roadmap für die Durchführung einer gezielten, auf der mpMRT basierenden Biopsie. Es sollte immer die in der mpMRT aggressivste Läsion (Index-Läsion) hinreichend biopsiert werden, um ein Understaging zu vermeiden. Die schematische PI-RADS Bezeichnung des jeweiligen Sektors sollte vom Biopseur in der Versandbezeichnung des jeweiligen Zylinders mit angegeben und im pathologischen Befundbericht vermerkt werden. Die mpMRT kann bei gesicherten Befunden zum (lokalen) Staging verwendet werden, wobei Aussagen zur Samenblaseninfiltration und einer Kapselüberschreitung mit guter Genauigkeit getroffen werden.
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Röthke, M. (2020). MRT der Prostata und strukturierte Befundung mittels PIRADS. In: Perner, S., Sailer, VW. (eds) Histopathologische Diagnostik der Prostatastanzbiopsie . Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-60643-8_15
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