MRI for Prostate Cancer Staging

Digital rectal exams for prostate cancer staging could become a thing of the past thanks to MRI. A new study in JAMA Network Open found that MRI performed as well as digital exams in determining the extent of prostate cancer disease.

Prostate cancer screening is moving closer to becoming a more widely accepted test, and MRI has played a major role in that evolution by enabling more precise workup of men with high PSA levels.

  • But what about other aspects of prostate cancer diagnosis and treatment, such as staging men found to have clinically significant disease? It turns out MRI has a role to play there as well. 

To learn more, researchers from Germany looked at data from 4.4k men with a median age of 66 and median PSA level of 7.4 ng/mL (anything over 3 ng/mL is typically referred for additional workup). All patients were scheduled for radical prostatectomy. 

  • Patients received digital rectal exams to assign clinical T stage and assess characteristics of cancer severity, such as local tumor extent, extracapsular extension, and seminal vesicle invasion. 

This was compared to multiparametric MRI scans on 1.5T or 3T systems, with data reported using the PI-RADS scale. The study’s primary outcome was distant metastasis-free survival. 

Among the patient cohort, researchers found…

  • MRI staging was slightly more accurate than digital exams for predicting biochemical recurrence-free survival (C index = 0.62, with 0.5 representing chance-level prediction and 1 indicating perfect prediction). 
  • And MRI was also better at predicting distant metastasis-free survival (C index = 0.67).
  • But MRI and digital exams were comparable when using four of the major prostate cancer risk classification systems in Europe.

What to make of the results? MRI didn’t have a huge advantage over digital rectal exams, but it was good enough for the authors to suggest that digital exams could be eliminated in favor of MRI workup instead.

  • That would enable clinicians to avoid many of the digital exam’s shortcomings, such as subjectivity, operator dependency, and restricted ability to assess extracapsular extension or seminal vesicle invasion.

The Takeaway

This week’s study shows that MRI’s role in prostate cancer diagnosis and treatment goes beyond just screening, and the digital rectal exam’s role for patient staging could soon become a thing of the past in all but a few cases. 

Mammo Modality Face-Off for Early Breast Cancer

When it comes to early breast cancer detection, which medical imaging modality is best: full-field digital mammography, digital breast tomosynthesis, or breast MRI? A new study in Clinical Radiology picks winners – and brings the receipts. 

Breast imagers are fortunate to have many technologies at their disposal, each with its own strengths and weaknesses. 

  • X-ray-based mammography tools like FFDM and DBT are easily available and relatively low cost, while breast MRI delivers the highest resolution but is expensive, less available, and more time-intensive to perform. 

So when does it make sense to use each modality? Researchers from China tested four techniques – FFDM, DBT, and breast MRI at 1.5T with accelerated and full protocols – in 329 patients with early-stage breast cancer (maximum tumor diameter ≤ 2 cm). 

  • They also analyzed results according to breast tissue density, as dense breast tissue is not only a cancer risk factor but can also obscure lesions on X-ray-based modalities.

Across the study sample, researchers found…

  • There was little difference in sensitivity between the four techniques for women with non-dense breast tissue, with FFDM, DBT, and accelerated breast MRI achieving 91% compared to 94% for full-protocol breast MRI.
  • But breast MRI pulled ahead in sensitivity for women with dense breast tissue, both with accelerated and full protocols (95% and 94%) beating DBT and FFDM (90% and 83%).
  • Accelerated breast MRI had performance comparable to the full protocol regardless of breast density, but at almost half the median scan time (8 vs. 15 minutes).
  • Accelerated and full-protocol breast MRI had the same specificity (94%), ahead of both DBT and FFDM (88% and 83%).

What to make of the results? Researchers said the findings in women with non-dense breast tissue reinforce that X-ray-based modalities are sufficient.

  • For women with dense breast tissue, accelerated breast MRI offers performance close enough to the full protocol that breast imaging practices can feel comfortable offering the faster exam.

The Takeaway

It’s no surprise that breast MRI beat both FFDM and DBT mammography for early breast cancer detection in women with dense breast tissue. But it is intriguing that there wasn’t much difference between breast MRI with either accelerated or full protocols. That’s good news for practices that want to make this powerful modality accessible to more women. 

Pediatric MRI Safety Surveyed

This past year has seen a renewed focus on MRI safety after a fatal accident in New York in 2025. Most of the attention has been on adult MRI, but what about kids? A new analysis in JACR finds that pediatric MRI accidents are fortunately rare, but occur often enough that continued vigilance is warranted. 

Pediatric MRI poses particular safety challenges to imaging facilities. Caregivers are often in the scanning room to comfort children, and sedation is frequently required to keep kids still during exams. 

  • But pediatric MRI safety hasn’t been studied as extensively as it has in adults, so researchers from five U.S. children’s hospitals reviewed MRI safety events that occurred at their facilities from 2017 to 2022.

Researchers focused on reported events that occurred within Zone IV, the area under the ACR’s four-zone safety model that includes the scanner room. They found…

  • A total of 146 safety events occurred in Zone IV out of 541k pediatric exams, for an event rate of 0.027%. 
  • An average of 4.9 events per year occurred at each site, or 3.3 events per 100k exams.
  • Event types involved projectiles (30%), burn/thermal injuries (13%), and implants (10%).
  • 78 events (53%) directly involved patients.
  • Ten events (6.8%) were classified as serious.

Frequent causes of events included medical equipment and supplies (anesthesia equipment and monitors, stethoscopes, and needles) and personal items like phones and badges.

  • Implanted devices like cochlear implants represent a growing challenge, as 20%-30% of children getting MRI scans have them, and safety events occurred despite sites following manufacturers’ guidelines. 

Why did the safety events happen? Study authors found that MRI safety protocols weren’t followed in 60% of events.

  • Lack of protocol adherence is a common refrain in MRI accidents that have involved adults, illustrating that all the guidelines and rules in the world won’t help if they aren’t followed to the letter.

The Takeaway

The new study on pediatric MRI safety highlights the fact that children shouldn’t just be treated like little adults when it comes to safe scanning procedures. The research offers a benchmark against which pediatric imaging facilities can measure themselves, while also offering additional guidance on mistakes to avoid when scanning kids.

Why MRI Providers Make Patient Comfort a Top Priority

Smart MRI providers know patient comfort is linked to profitability. After all, the comfort quotient impacts image quality, diagnostic accuracy, operational efficiency, and patient satisfaction. 

  • Yet at least one-third of adult patients report distress, moderate anxiety, and discomfort related to MRI, according to a systematic review involving 220 patients.

When patients are claustrophobic or uncomfortable, it negatively impacts MRI providers…

  • Fidgety patients lead to motion artifacts/poor quality images and the need to retake scans – impacting overall productivity.
  • Sedating patients requires additional safety precautions, costing time and money.
  • Cancellations and no-shows due to patient anxiety translate to lost revenue.
  • Patients who have an uncomfortable MRI experience may go elsewhere next time – reducing repeat business and word-of-mouth referrals.

But it doesn’t have to be this way. Providers should seek out high-performance MRI systems designed with patient comfort in mind…

  • Shorter scans – The shorter the scan, the easier it is for patients to stay still. Fujifilm’s ECHELON Synergy MRI features up to 50% scan time reduction over previous generation 1.5T MRI scanners, and a 70-cm-wide bore with a 62-cm-wide table to enhance comfort.
  • Software tools – A study found that 15-20% of MRI scans require re-scan due to patient motion. ECHELON Synergy offers software that mitigates the impact of motion artifacts, making it easier and quicker to complete scans on fidgety patients.
  • Open design – Put claustrophobic patients at ease and scanning needn’t stop mid-way through an exam. Providers are alleviating anxiety and boosting efficiency with Fujifilm’s OASIS Velocity MRI, which features a true open design, where patients have an unobstructed view for maximum comfort. OASIS Velocity also supports patients who weigh up to 660 pounds.
  • Easy access – Improving comfort for all patient populations can help keep a facility competitive. Fujifilm’s APERTO Lucent is a powerful permanent magnet open-sided 0.4T MRI that delivers an optimal patient experience. Its unique single-pillar design provides ideal technologist-patient access, and the wide, laterally moving table lowers to 20 inches, ensuring easy access for pediatric, elderly, and/or injured patients.

Hospitals and imaging facilities across the U.S. rely on Fujifilm for state-of-the-art, patient-centric MRI systems. For example…

Make patient comfort a top priority and give your MRI business a competitive edge with solutions from FUJIFILM Healthcare Americas Corp

Uneven Access to Brain MRI

Patients from disadvantaged neighborhoods or those traveling farther for brain MRI scans presented in worse clinical condition than patients with better access. That’s according to a new JACR study that reopens the debate over disparities in healthcare access. 

The past several years have seen numerous studies published that document disparities in healthcare access and their impact on clinical outcomes.

Many previous studies have also concentrated on access to care in rural areas, in which long distances make it harder for patients to travel to medical centers.

  • In the current study, researchers led by authors from Emory University flipped the script to examine care access in the Atlanta metropolitan area in an effort to quantify how distance and socioeconomic status might impact patient care. 

They examined the demographic backgrounds of 4.8k patients who got brain MRI scans over a one-year period starting in March 2019, calculating factors like distance from home to imaging facility and socioeconomic status based on the area deprivation index. 

  • They then correlated these data to patient illness severity – also known as acuity – when they presented for their scans, using a three-point scale ranging from normal (level 1) to findings requiring a change in patient management (level 3).

Based on the data, researchers found…

  • Patients in neighborhoods with lower socioeconomic status had 34% higher odds of level 2 acuity versus level 1 for inpatient scans and 27% higher for emergency scans. 
  • Patients living twice the distance from an imaging facility had 6.5% higher odds of level 2 acuity compared to level 1, and 15% higher for level 3.
  • Other factors affecting acuity level included age, race, and insurance status.
  • Medicaid recipients in particular were sicker, with 68% higher odds of acuity level 2 and 81% higher odds of acuity level 3 compared to those with commercial insurance. 

The findings track with other studies that have linked chronic health conditions with brain pathologies, such as the connection between diabetes and stroke. 

The Takeaway

The new findings offer additional details on how patient demographics affect both their health status and their access to care, in particular for advanced imaging scans like brain MRI. Follow-up studies could examine whether a similar phenomenon occurs with CT, which is the workhorse modality for emergency imaging. 

Why Radiology Leaders Are Turning to AI – And Why They’re Not Looking Back

From single-scanner clinics to university hospitals, radiology leaders around the globe face the same challenge: keeping up with rising patient demand while managing costs.

MRI volumes are climbing. Scanner hours and budgets? Not so much.

  • Under pressure to do more with less, decision-makers are reaching a conclusion that was unthinkable just a few years ago: AI-powered MRI is no longer a novelty – it’s a necessity.

No matter the size or scale of the operation, diagnostic imaging providers face a familiar set of challenges:

  • High capital costs – New scanners cost seven figures, and upgrades run hundreds of thousands.
  • Limited capacity – Most sites can’t easily add scanners, staff, or hours to meet demand.
  • Rising demand – MRI volume continues to grow as chronic conditions rise and preventive care gains traction.
  • Patient expectations – Long, uncomfortable exams frustrate patients who may look elsewhere.

AI offers a path forward, helping imaging teams handle more studies without compromising diagnostic standards.

AIRS Medical built SwiftMR, AI-powered MRI reconstruction software, to meet today’s imaging challenges. Hospitals and clinics in over 35 countries use SwiftMR to:

  • Reduce scan times by up to 50% compared to standard protocols.
  • Deliver sharper images radiologists can trust.
  • Enhance the patient experience with shorter exams and fewer motion-related rescans.

SwiftMR is vendor-neutral, compatible with all MRI makes, models, and field strengths.

FDA-cleared, MDR-certified, and clinically validated, SwiftMR is trusted by over 300 imaging providers in the U.S. and over 1,000 globally, including:

These outcomes show that AI-powered MRI delivers tangible operational, clinical, and financial benefits across site types and geographies. 

Watch this video to learn more about SwiftMR.

The Takeaway

Radiology leaders are relying on SwiftMR to transform how they deliver care. From enterprise networks to single-scanner clinics, imaging teams are unlocking new levels of efficiency and patient care.

AI for Brain MRI

What if you could speed up brain MRI exams by performing fast scans for most patients, and reserving complex sequences for the patients who need them? A hint of that future comes from a new study in which AI showed progress in helping radiologists interpret scans with fewer sequences.

MRI can visualize minute structures in the body, especially in the brain, but it’s one of the trickiest imaging modalities to operate.

  • There’s an alphabet soup of MRI pulse sequences, and the modality’s complexity is multiplied when contrast has to be used. 

Breast MRI experts have been experimenting with abbreviated scanning protocols that speed up image acquisition and interpretation by using fewer and less complex sequences.

  • Researchers applied that concept to MRI brain imaging in a new European Journal of Radiology paper in which they tested Cerebriu’s Apollo AI algorithm with 414 patients from four hospitals in Denmark.

Apollo processes three brain MRI sequences (DWI, SWI or T2* GRE, and T2-FLAIR) and can detect critical findings like brain infarcts and intracranial hemorrhages and tumors while the patient is still on the table.

  • If an abnormality is detected, Apollo prompts technologists to acquire a fourth sequence, such as T1-weighted imaging.

That sounds great, but how well does Apollo work in the real world? 

  • Researchers compared the algorithm’s performance to that of expert neuroradiologists in multiple workflows, such as reading three- and four-sequence MRI scans with and without AI assistance. 

Compared to neuroradiologists using the four-sequence MRI protocol without AI assistance, they found…

  • Apollo’s sensitivity was better than neuroradiologists for brain infarcts (94% vs. 89%) and intracranial tumors (74% vs. 71%) but slightly lower for intracranial hemorrhages (82% vs. 83%).
  • AI’s specificity was somewhat lower, however, for brain infarcts (86% vs. 99%), intracranial hemorrhages (84% vs. 99%), and intracranial tumors (62% vs. 97%). 
  • When neuroradiologists had AI findings in addition to the four-sequence protocol, tumor detection sensitivity improved slightly, but specificity fell. 

While Apollo’s sensitivity was a benefit, the researchers said its low specificity “presents a challenge” and could result in unnecessary additional sequences or contrast administration. 

  • Specificity could be affected by age-related changes in older patients, as well as differences in MRI scanner models used.

The Takeaway

The new findings show that AI-aided MRI scan assistance still needs refinement. But it’s still early days for Cerebriu and Apollo (which has the CE Mark but not FDA clearance), so watch this space for more updates. 

MRI of Bullet Fragments Is Possible

Radiology has a renewed focus on MRI safety following the tragic death of a New York man in an MRI accident last month. With that in mind, a new JACR study looks at adverse MRI events caused by an uncommon but still important phenomenon: retained bullet fragments in patients getting scans. 

MRI is radiology’s most powerful modality, but its strong magnetic fields can be hazardous – and on extremely rare occasions even fatal – for both patients and medical personnel.

  • Patients are supposed to be screened for metallic implants, jewelry, and other contraindications, but how often do providers know to ask about retained bullet fragments?

Having a retained bullet fragment on its own isn’t a contraindication for MRI, but providers do need to know where fragments are located and how large they are.

  • If pre-scan screening discovers a patient with a retained fragment, they typically receive X-rays of the involved area to determine location and size – scans should be aborted if the fragment is in a solid organ or within 5 mm of an important artery or vein.

If all these steps are taken and the scan goes ahead, how often do adverse MRI events occur? 

  • Researchers reviewed 6.1k X-ray reports that contained the terms “bullet” or “shrapnel” over 13 years, finding 284 patients who got an MRI scan after a retained fragment was found on radiography.

They found…

  • Only four patients (1.8%) experienced symptoms during MRI scans.
  • Each of the exams was terminated early due to patient discomfort, with three patients reporting burning and one general discomfort.
  • None of the symptomatic exams had the bullet in the MRI field of view.
  • No serious injury and no follow-up care was required. 

The Takeaway

The new findings are encouraging by showing that with careful patient screening and monitoring, MRI scans can be performed on patients with retained bullet fragments. But as always, MRI operators must remain vigilant and adhere to published MRI safety guidelines.

MRI Reveals Junk Food’s Toll on Carotid Arteries

As the U.S. government weighs a regulatory crackdown on ultra-processed food, a new study indicates the feds may be on to something. Researchers used MRI to discover that people who consumed more ultra-processed food had higher levels of carotid arterial plaque – a risk factor for cardiovascular disease. 

The FDA and the USDA on July 23 announced the start of a new initiative to investigate the risks of ultra-processed foods and their relationship to chronic diseases such as obesity, heart disease, and cancer. 

  • The project is widely seen as a priority of HHS Secretary Robert F. Kennedy, Jr. and his Make America Healthy Again movement. 

Meanwhile, arterial plaque buildup is a sign of atherosclerosis and has been linked to multiple clinical conditions, from stroke to intraplaque hemorrhage

In the new paper in American Journal of Preventive Cardiology, researchers noted the established association between adverse cardiovascular events and consumption of ultra-processed food and beverages, but the association with subclinical disease hasn’t been explored. 

  • So researchers reviewed carotid MRI scans of 768 participants from the Atherosclerosis Risk in Communities study, in which subjects also described their dietary intake with a 148-item questionnaire. 

MRI scans were correlated with dietary habits, finding that compared to the lowest quartile, people in the highest quartile of ultra-processed food consumption had…

  • Greater total arterial wall volume. 
  • Greater total lipid core volume and maximum lipid core area.
  • Higher maximum segmental wall thickness.

No correlation was found between arterial plaque and other types of diet measures, such as carbohydrate and fat intake or glycemic load index.

  • The findings suggest that much of the negative health effect from ultra-processed foods comes from their contribution to arterial plaque buildup, which could occur through their unfavorable nutrient profile leading to alterations in blood lipids.

The Takeaway

In today’s hyperpolarized political environment – in which scientific inquiry is often subordinated to already-solidified beliefs – the new findings connecting MRI measurements of carotid artery plaque to ultra-processed foods offer a foundation for public policy changes that could indeed improve the health of Americans.

MRI Accident Turns Deadly

A tragic MRI accident in Long Island, New York, has turned deadly. A man who was pulled into a mobile MRI scanner by a heavy chain he was wearing died of his injuries. 

Keith McAllister was waiting outside a mobile MRI trailer operated by Nassau Open MRI on Long Island as his wife received a knee scan.

  • McAllister was wearing a weight-training chain around his neck that weighed some 20 pounds.

When he entered the trailer to help his wife get off the scanner table, the system’s powerful 1.5T magnetic field drew him against the magnet. It took staff an hour to free him.

Investigators are still looking into the details of the episode, but it underscores the shortcomings in how MRI safety is regulated in the U.S., where fatal MRI accidents are extremely rare but still do occur.  

  • That’s according to MRI safety expert Tobias Gilk, vice president at architectural firm Radiology Planning and founder of Gilk Radiology Consultants, who spoke to The Imaging Wire about the accident.

The U.S. has some of the most comprehensive and sophisticated guidelines on MRI safety, encapsulated in the ACR Manual on MR Safety.

  • What’s more, the radiology community including ACR, ISMRM, ASRT, and others are currently observing their annual MR Safety Week to promote safe MRI scanning – an event that started just a few days after McAllister died.

But despite the great leaps in knowledge about MRI safety, Gilk believes that keeping patients safe is complicated by the exponential growth in the modality’s complexity, while actual enforcement of safety standards is lacking. 

  • Many state health departments don’t even address MRI safety as they focus more aggressively on regulating ionizing imaging modalities like CT and X-ray, and healthcare certification bodies like the Joint Commission lack enforcement teeth.

Instead, MRI safety often becomes the responsibility of technologists who frequently must juggle multiple tasks as they manage both patients and scanner operations.

  • This can be particularly challenging in mobile MRI coaches, often staffed by a single MRI technologist where the only barrier between the outside world and the scanning environment is just a single – often unlocked – door. 

The Takeaway

The tragic death of Keith McAllister in a mobile MRI trailer shows that all the guidelines and safety events in the world won’t keep patients safe unless accompanied by stronger enforcement of the knowledge the radiology community already has. We can do better.

Get every issue of The Imaging Wire, delivered right to your inbox.