Negative Multiparametric Magnetic Resonance Imaging for Prostate Cancer: What's Next?

Panebianco, Valeria; Barchetti, Giovanni; Simone, Giuseppe; Monte, Maurizio Del; Ciardi, Antonio; Grompone, Marcello Domenico; Campa, Riccardo; Indino, Elena Lucia; Barchetti, Flavio; Sciarra, Alessandro; Leonardo, Costantino; Gallucci, Michele; Catalano, Carlo

doi:10.1016/j.eururo.2018.03.007

Cited by 155 publications

(107 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recently, Panebianco et al. found similar follow‐up results in patients with negative mpMRI, after a median follow‐up of 38 and 60 months in biopsy naïve patients and patients with previous negative TRUS biopsy, respectively. Previously, De Visschere et al.…”

Section: Discussionmentioning

confidence: 70%

Multiparametric magnetic resonance imaging and follow‐up to avoid prostate biopsy in 4259 men

et al. 2019

View full text Add to dashboard Cite

Objective To determine the proportion of men avoiding biopsy because of negative multiparametric magnetic resonance imaging (mpMRI) findings in a prostate MRI expert centre, and to assess the number of clinically significant prostate cancers (csPCa) detected during follow‐up. Patients and methods Retrospective study of 4259 consecutive men having mpMRI of the prostate between January 2012 and December 2017, with either a history of previous negative transrectal ultrasonography‐guided biopsy or biopsy naïve. Patients underwent mpMRI in a referral centre. Lesions were classified according to Prostate Imaging Reporting And Data System (PI‐RADS) versions 1 and 2. Negative mpMRI was defined as an index lesion PI‐RADS ≤2. Follow‐up until 13 October 2018 was collected by searching the Dutch Pathology Registry (PALGA). Gleason score ≥3 + 4 was considered csPCa. Kaplan–Meier analysis and univariable logistic regression models were used in the cohort of patients with negative mpMRI and follow‐up. Results Overall, in 53.6% (2281/4259) of patients had a lesion classified as PI‐RADS ≤2. In 320 patients with PI‐RADS 1 or 2, follow‐up mpMRI was obtained after a median (interquartile range) of 57 (41–63) months. In those patients, csPCa diagnosis‐free survival (DFS) was 99.6% after 3 years. Univariable logistic regression analysis revealed age as a predictor for csPCa during follow‐up (P < 0.05). In biopsied patients, csPCa was detected in 15.8% (19/120), 43.2% (228/528) and 74.5% (483/648) with PI‐RADS 3, 4 and 5, respectively. Conclusion More than half of patients having mpMRI of the prostate avoided biopsy. In those patients, csPCa DFS was 99.6% after 3 years.

show abstract

Section: Discussionmentioning

confidence: 70%

Multiparametric magnetic resonance imaging and follow‐up to avoid prostate biopsy in 4259 men

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Moreover, evaluation of mpMRI depends on multiple factors, including radiologist experience, lesion size, and lesion location. 36,[48][49][50][51] Although more prospective evidence is needed, these data support the use of TRUS biopsy in this patient population. For these reasons, the NCCN Guidelines for PCa recommend a general "prostate biopsy" for initial clinical assessment that is not specific to conventional TRUS or MR-TRUS.…”

Section: Biological Limitationsmentioning

confidence: 67%

Current Status of MRI and PET in the NCCN Guidelines for Prostate Cancer

Mason

Eastham

Davis³

et al. 2019

Journal of the National Comprehensive Cancer Network

View full text Add to dashboard Cite

Prostate cancer (PCa) represents a significant source of morbidity and mortality for men in the United States, with approximately 1 in 9 being diagnosed with PCa in their lifetime. The role of imaging in the evaluation of men with PCa has evolved and currently plays a central role in diagnosis, treatment planning, and evaluation of recurrence. Appropriate use of multiparametric MRI (mpMRI) and MRI-guided transrectal ultrasound (MR-TRUS) biopsy increases the detection of clinically significant PCa while decreasing the detection of clinically insignificant PCa. This process may help patients with clinically insignificant PCa avoid the adverse effects of unnecessary therapy. In the setting of a known PCa, patients with low-grade disease can be observed using active surveillance, which often includes a combination of prostate-specific antigen (PSA) testing, serial mpMRI, and, if indicated, follow-up systematic and targeted TRUS-guided tissue sampling. mpMRI can provide important information in the posttreatment setting, but PET/CT is creating a paradigm shift in imaging standards for patients with locally recurrent and metastatic PCa. This article examines the strengths and limitations of mpMRI for initial PCa diagnosis, active surveillance, recurrent disease evaluation, and image-guided biopsies, and the use of PET/CT imaging in men with recurrent PCa. The goal of this review is to provide a rational basis for current NCCN Clinical Practice Guidelines in Oncology for PCa as they pertain to the use of these advanced imaging modalities.

show abstract

“…In those patients, a significant number of csPCa might have been missed. Thus, systematic biopsies are still recommended for these patients although they have higher risk of complications along with economic burdens [9][10][11]. Several studies have reported a strong correlation between higher grade tumors and higher category of PI-RADS [12,13,19,21].…”

Section: Discussionmentioning

confidence: 99%

“…Subsequently, many authorities have recommended surveillance alone without biopsy for patients with PI-RADSv2 category 1 or 2 [31]. However, there is paucity of data concerning the intermediate and long-term follow-up and their correlation with RP pathologic outcomes [11]. In addition, according to a BioMed Research International recent meta-analysis, there is no definitive conclusion about the NPV of mpMRI [4].…”

Section: Discussionmentioning

confidence: 99%

“…Notably, in the majority of studies using PI-RADS, a category of ≥3 was considered as targetable lesion for biopsy to evaluate its performance in detecting PCa [1,[7][8][9][10][11][12][13][14][15]. Studies on PI-RADS category 1 and 2 lesions are lacking [11][12][13][14]. To the best of our knowledge, no studies have directly compared category 1 and 2 lesions.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparing Prostate Imaging-Reporting and Data System Version 2 (PI-RADSv2) Category 1 and 2 Groups: Clinical Implication of Negative Multiparametric Magnetic Resonance Imaging

Kim

Lee

Hwang

et al. 2020

BioMed Research International

View full text Add to dashboard Cite

Objectives. To evaluate the clinicopathological differences between Prostate Imaging-Reporting and Data System (PI-RADS) version 2 (v2) category 1 and 2 groups. Materials and Methods. We retrospectively reviewed our two institutional clinical databases: (1) transrectal ultrasound (TRUS)/magnetic resonance imaging (MRI) fusion biopsy cohort (n=706) and (2) radical prostatectomy (RP) cohort (n=1403). Subsequently, we performed comparative analyses between PI-RADSv2 category 1 and 2 groups. Clinically significant prostate cancer (csPCa) was defined as the presence of Gleason score GS≥3+4 in a single biopsy core, and adverse pathology (AP) was defined as high-grade (primary Gleason pattern 4 or any pattern 5) and/or non-organ-confined disease (pT3/N1). We also performed multivariate logistic regression analyses for AP. Results. In the TRUS/MRI fusion biopsy cohort, no significant differences in detection rates of all cancer (18.2% vs. 29.0%, respectively, P=0.730) or csPCa (9.1% vs. 9.9%, respectively, P=0.692) were observed between PI-RADSv2 category 1 and 2 groups. There were no significant differences in pathologic outcomes including Gleason score (≥4+3, 21.2% vs. 29.9%, respectively, P=0.420) or detection rate of AP (27.3% vs. 33.8%, respectively, P=0.561) between the two groups in the RP cohort either. PI-RADSv2 category 1 or 2 had no significant association with AP, even in univariate analysis (P=0.299). Conclusions. PI-RADSv2 categories 1 and 2 had similar performance to predict clinicopathological outcomes. Consequently, these two categories may be unified into a single category. Negative mpMRI does not guarantee the absence of AP, as with csPCa.

show abstract

Negative Multiparametric Magnetic Resonance Imaging for Prostate Cancer: What's Next?

Cited by 155 publications

References 30 publications

Multiparametric magnetic resonance imaging and follow‐up to avoid prostate biopsy in 4259 men

Multiparametric magnetic resonance imaging and follow‐up to avoid prostate biopsy in 4259 men

Current Status of MRI and PET in the NCCN Guidelines for Prostate Cancer

Comparing Prostate Imaging-Reporting and Data System Version 2 (PI-RADSv2) Category 1 and 2 Groups: Clinical Implication of Negative Multiparametric Magnetic Resonance Imaging

Contact Info

Product

Resources

About