Role of Changes in Magnetic Resonance Imaging or Clinical Stage in Evaluation of Disease Progression for Men with Prostate Cancer on Active Surveillance

Chesnut, Gregory T.; Vertosick, Emily; Benfante, Nicole; Sjoberg, Daniel D.; Fainberg, Jonathan; Lee, Taehyoung; Eastham, James A.; Laudone, Vincent P.; Scardino, Peter T.; Touijer, Karim; Vickers, Andrew; Ehdaie, Behfar

doi:10.1016/j.eururo.2019.12.009

Cited by 65 publications

(54 citation statements)

References 22 publications

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“…Interestingly, all radiologists in this review were regarded as experienced based on the criteria set by a recently published Cochrane review, and hence radiology experience was not used as a covariate for a metaregression analysis [15]. A number of studies have reported significant variation in mp-MRI reporting amongst radiologists, uninfluenced by experience measured either in years or in the number of mp-MRI examinations reported, suggesting that experience does not necessarily reflect expertise [16][17][18][19][20][21]25]. Additionally, variation in MRI acquisition and quality of images will further influence diagnostic accuracy at an institutional level [29].…”

Section: Discussionmentioning

confidence: 99%

“…A total of 28 references were retrieved for a comprehensive evaluation. Seven studies were included in quantitative analysis [17][18][19][20][21][22]. The PRISMA flow chart is shown in Fig.…”

Section: Literature Searchmentioning

confidence: 99%

“…1 Included studies Three studies were prospective cohort studies [17,22,23]. Four studies were retrospective in nature [18][19][20][21][22][23]. A total of 800 patients with low-or intermediate-risk prostate cancer were included in this review.…”

Section: Literature Searchmentioning

confidence: 99%

“…In six studies 3 T MRI was used [17][18][19][20][21]23], and in one study 1.5 T MRI was used [22]. Five studies used PIRADS v.2 or Likert scale for prostate lesions [17,18,21,[19][20][21][22][23]. Two studies used an independent scoring system [19,20].…”

Section: Literature Searchmentioning

confidence: 99%

“…Index test-mp-MRI All seven studies were used for a meta-analysis of diagnostic accuracy of mp-MRI [17][18][19][20][21][22].…”

Section: Sensitivity and Specificity Analysismentioning

confidence: 99%

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Can the Use of Serial Multiparametric Magnetic Resonance Imaging During Active Surveillance of Prostate Cancer Avoid the Need for Prostate Biopsies?—A Systematic Diagnostic Test Accuracy Review

Hettiarachchi

Geraghty

Rice

et al. 2021

European Urology Oncology

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Section: Discussionmentioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

Section: Literature Searchmentioning

confidence: 99%

“…Index test-mp-MRI All seven studies were used for a meta-analysis of diagnostic accuracy of mp-MRI [17][18][19][20][21][22].…”

Section: Sensitivity and Specificity Analysismentioning

confidence: 99%

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Can the Use of Serial Multiparametric Magnetic Resonance Imaging During Active Surveillance of Prostate Cancer Avoid the Need for Prostate Biopsies?—A Systematic Diagnostic Test Accuracy Review

Hettiarachchi

Geraghty

Rice

et al. 2021

European Urology Oncology

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Improving multiparametric MR‐transrectal ultrasound guided fusion prostate biopsies with hyperpolarized ¹³C pyruvate metabolic imaging: A technical development study

Chen

Bok

Cooperberg

et al. 2022

Magnetic Resonance in Med

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To develop techniques and establish a workflow using hyperpolarized carbon-13 ( 13 C) MRI and the pyruvate-to-lactate conversion rate (k PL ) biomarker to guide MR-transrectal ultrasound fusion prostate biopsies. Methods:The integrated multiparametric MRI (mpMRI) exam consisted of a 1-min hyperpolarized 13 C-pyruvate EPI acquisition added to a conventional prostate mpMRI exam. Maps of k PL values were calculated, uploaded to a picture archiving and communication system and targeting platform, and displayed as color overlays on T 2 -weighted anatomic images. Abdominal radiologists identified 13 C research biopsy targets based on the general recommendation of focal lesions with k PL >0.02(s −1 ), and created a targeting report for each study. Urologists conducted transrectal ultrasound-guided MR fusion biopsies, including the standard 1 H-mpMRI targets as well as 12-14 core systematic biopsies informed by the research 13 C-k PL targets. All biopsy results were included in the final pathology report and calculated toward clinical risk.Results: This study demonstrated the safety and technical feasibility of integrating hyperpolarized 13 C metabolic targeting into routine 1 H-mpMRI and transrectal ultrasound fusion biopsy workflows, evaluated via 5 men (median age 71 years, prostate-specific antigen 8.4 ng/mL, Cancer of the Prostate Risk Assessment score 2) on active surveillance undergoing integrated scan and subsequent biopsies. No adverse event was reported. Median turnaround time was less than 3 days from scan to 13 C-k PL targeting, and scan-to-biopsy time

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Diagnostic performance of microUltrasound at MRI‐guided confirmatory biopsy in patients under active surveillance for low‐risk prostate cancer

et al. 2023

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Background Active surveillance (AS) represents a standard of care of low‐risk prostate cancer (PCa). However, the identification and monitoring of AS candidates remains challenging. Microultrasound (microUS) is a novel high‐resolution imaging modality for transrectal ultrasonography (TRUS). We explored the impact of microUS TRUS and targeted biopsies in mpMRI‐guided confirmatory biopsies. Methods Between October 2017 and September 2021, we prospectively enrolled 100 patients scheduled for MRI‐guided confirmatory biopsy at 1 year from diagnosis of ISUP 1 PCa. TRUS was performed using the ExactVu microUS system; PRI‐MUS protocol was applied to identify suspicious lesions (i.e., PRIMUS score ≥ 3). All patients received targeted biopsies of any identified microUS and mpMRI lesions and complementary systematic biopsies. The proportion of patients upgraded to clinically significant PCa (defined as ISUP ≥ 2 cancer; csPCa) at confirmatory biopsies was determined, and the diagnostic performance of microUS and mpMRI were compared. Results Ninety‐two patients had a suspicious MRI lesion classified PI‐RADS 3, 4, and 5 in respectively 28, 16, and 18 patients. MicroUS identified 82 patients with suspicious lesions, classified as PRI‐MUS 3, 4, and 5 in respectively 20, 50, and 12 patients, while 18 individuals had no lesions. Thirty‐four patients were upgraded to ISUP ≥ 2 cancer and excluded from AS. MicroUS and mpMRI showed a sensitivity of 94.1% and 100%, and an NPV of 88.9% and 100%, respectively, in detecting ISUP ≥ 2 patients. A microUS‐mandated protocol would have avoided confirmatory biopsies in 18 patients with no PRI‐MUS ≥ 3 lesions at the cost of missing four upgraded patients. Conclusions MicroUS and mpMRI represent valuable imaging modalities showing high sensitivity and NPV in detecting csPCa, thus allowing their use for event‐triggered confirmatory biopsies in AS patients. MicroUS offers an alternative imaging modality to mpMRI for the identification and real‐time targeting of suspicious lesions in AS patients.

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Role of Changes in Magnetic Resonance Imaging or Clinical Stage in Evaluation of Disease Progression for Men with Prostate Cancer on Active Surveillance

Cited by 65 publications

References 22 publications

Can the Use of Serial Multiparametric Magnetic Resonance Imaging During Active Surveillance of Prostate Cancer Avoid the Need for Prostate Biopsies?—A Systematic Diagnostic Test Accuracy Review

Can the Use of Serial Multiparametric Magnetic Resonance Imaging During Active Surveillance of Prostate Cancer Avoid the Need for Prostate Biopsies?—A Systematic Diagnostic Test Accuracy Review

Improving multiparametric MR‐transrectal ultrasound guided fusion prostate biopsies with hyperpolarized ¹³C pyruvate metabolic imaging: A technical development study

Diagnostic performance of microUltrasound at MRI‐guided confirmatory biopsy in patients under active surveillance for low‐risk prostate cancer

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Role of Changes in Magnetic Resonance Imaging or Clinical Stage in Evaluation of Disease Progression for Men with Prostate Cancer on Active Surveillance

Cited by 65 publications

References 22 publications

Can the Use of Serial Multiparametric Magnetic Resonance Imaging During Active Surveillance of Prostate Cancer Avoid the Need for Prostate Biopsies?—A Systematic Diagnostic Test Accuracy Review

Can the Use of Serial Multiparametric Magnetic Resonance Imaging During Active Surveillance of Prostate Cancer Avoid the Need for Prostate Biopsies?—A Systematic Diagnostic Test Accuracy Review

Improving multiparametric MR‐transrectal ultrasound guided fusion prostate biopsies with hyperpolarized 13C pyruvate metabolic imaging: A technical development study

Diagnostic performance of microUltrasound at MRI‐guided confirmatory biopsy in patients under active surveillance for low‐risk prostate cancer

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Improving multiparametric MR‐transrectal ultrasound guided fusion prostate biopsies with hyperpolarized ¹³C pyruvate metabolic imaging: A technical development study