Scoring systems used for the interpretation and reporting of multiparametric MRI for prostate cancer detection, localization, and characterization: could standardization lead to improved utilization of imaging within the diagnostic pathway?

Abstract

Multiparametric magnetic resonance imaging (mpMRI) is increasingly being used earlier in the prostate cancer diagnostic pathway in order to detect and localize disease. Its results can be used to help decide on the indication, type, and localization of a prostate biopsy for cancer diagnosis. In addition, mpMRI has the potential to contribute information on the characterization, or aggressiveness, of detected cancers including tumor progression over time. There is considerable variation in the way results of different MRI sequences are reported. We conducted a review of scoring systems that have been used in the detection and characterization of prostate cancer. This revealed that existing scoring and reporting systems differ in purpose, scale, and range. We evaluate these differences in this review. This first step in collating all methods of scoring and reporting mpMRI will ultimately lead to consensus approaches to develop a standardized reporting scheme that can be widely adopted and validated to ensure comparability of research outputs and optimal clinical practice.

A system of a unified approach to interpreting prostate magnetic resonance imaging according to the PI-RADSv2 guidelines

“…Клиническое использование МРТ при РПЖ на се-годня не ограничивается вопросами локорегионарно-го распространения, а используется для решения таких задач, как выявление опухоли, четкое определение ее анатомо-топографической локализации, подробная характеристика, стратификация по риску прогресси-рования, ведение активного наблюдения, выявление возможного рецидива, навигация при биопсии, пла-нирование операции и фокальной и внешней лучевой терапии [6][7][8].…”

How are we going to train a generation of radiologists (and urologists) to read prostate MRI?

“…According to recent guidelines, physicians appreciate standardized MRI prostate reporting of lesions along with a prose report [6][7][8]. Several items on what urologists (and clinicians) expect from prostate multiparametric-MRI data, and from its standardized reporting are detailed in Table 1.…”

“…), and easy data collection or comparison. Therefore, according to most authors [1,2,[5][6][7]30,31,33 & ], its format has to be structured, and its content to be in a standardized and understandable terminology. We describe a framework and the fundamental content of a standardized prostate multiparametric-MRI report in Table 2.…”

Prostate Cancer: The Role of Multiparametric Magnetic Resonance Imaging

“…[1][2][3][4][5][6] Its use for detection, localization and staging of prostate cancer has been increasing over the last years; in many centers, it has been essentially used when there's high cancer suspicion despite negative transrectal ultrasound (TRUS) guided biopsy findings. 7,8 Actually, patients with abnormal PSA and negative biopsy represent a particular population, which simultaneously needs a high sensitivity evaluation (able to accurately pinpoint cancers missed at biopsy) and an imaging tool with high negative predictive value (in order to avoid an unnecessary repeat biopsy). The value of MRI on prostate cancer has however been extended to cases of recurrence suspicion, active surveillance, refused biopsy, MRI-guided biopsy, and also MRI-US fusion technology to improve the accuracy of USguided biopsies.…”