Magnetic Resonance Fingerprinting and ADC mapping to optimize Biopsy Decision-Making in patients with a Negative Prostate MRI

Motivation: Prostate MRI alone cannot avoid all unnecessary biopsies in MRI-negative patients. This results in overdiagnosis, added morbidity and overtreatment. Goal(s): Investigate if MRF-derived T1 and T2 maps alone or in combination with conventional ADC mapping can reduce unnecessary biopsies while maintaining optimal significant prostate cancer detection. Approach: Regions of interest encompassing the right and left lobes of the peripheral zone were used to compute the mean T1, T2, and ADC values. Results: With a linear regression of mean T1 and T2 values, 63% of all biopsies could be avoided, at the cost of missing one significant prostate cancer. Impact: The use of MR Fingerprinting in prostate biopsy decision-making pathways could reduce unnecessary biopsies while maintaining optimal detection of significant prostate cancer in MRI-negative patients with clinically indicated biopsies. The prospective validation of these findings is crucial for patient outcomes.