The role of magnetic resonance imaging in the diagnosis and management of prostate cancer

Thompson, James; Lawrentschuk, Nathan; Frydenberg, Mark; Thompson, Les; Stricker, Phillip D.

doi:10.1111/bju.12381

Cited by 136 publications

(104 citation statements)

References 131 publications

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“…In previous reports, the detection rate of PCa in biopsed PI-RADS 3 lesions has shown a significantly high variability, ranging from 5% to 26%. [23][24][25] PCa is often a solid lesion with a defined three dimensional shape. Consequently a major diagnostic potential of MRI lesion volume for suspicious PCa might be proposed to identify PI-RADS 3 lesions to be biopsied.…”

mentioning

confidence: 99%

Score 3 prostate lesions: a gray zone for PI-RADS v2

Scialpi

Martorana

Aisa

et al. 2017

Turkish Journal of Urology

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Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) does not offer a precise guidance on the clinical management (biopsy or not biopsy) for PI-RADS v2 score 3 lesions. Lesion volume calculated on biparametric MRI (bpMRI) [T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI)] by introducing a cut-off of 0.5 mL, allows to distinguish the lesions assigned by the multiparametric MRI (mpMRI) to the category PI-RADS v2 score 3 in two subgroups: a) Indolent or low risk lesions with volume <0.5 mL, and b) Significant or high risk lesions with volume ≥0.5 mL. For mpMRI lesions assigned to PI-RADS v2 score 3, we suggest the following management: 1) Subgroup a (low-risk lesion): Clinical surveillance (accurate evaluation of age and clinical informations, periodic monitoring of prostate specific antigen value and repeated bpMRI 1 year later); 2) Subgroup b (high-risk lesion): Targeted biopsy. The proposed management would reduce the use of unnecessary biopsies and increase the diagostic yield of significant prostate cancer of approximately 50% and 30% respectively. These approaches encourage the radiologist to adopt MRI lesion volume to improve PI-RADS v2 and to optimize the management of PI-RADS v2 score 3 lesions.

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confidence: 99%

Score 3 prostate lesions: a gray zone for PI-RADS v2

Scialpi

Martorana

Aisa

et al. 2017

Turkish Journal of Urology

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“…The rapid optimization of MRI technology has led to functional imaging using diffusion-weighted, dynamic contrast-enhanced and spectroscopic imaging. Combining these functional techniques with the traditional (T1/T2) techniques (parameters) resulted in a multi parametric MRI (mpMRI) which has led to improved diagnostic performance for the detection of high grade lesions [19].…”

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confidence: 99%

The role of the multiparametric MRI in the diagnosis of prostate cancer in biopsy-naïve men

Rhudd

McDonald

Emberton

et al. 2017

Current Opinion in Urology

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Purpose of review: To review the role of pre-biopsy multi-parametric MRI in biopsy-naïve men for the detection of clinically significant prostate cancer.Recent findings: Recent Level 1 evidence shows that multi-parametric MRI has high sensitivity and negative predictive value for the detection of clinically significant prostate cancer in biopsy-naïve men. Concurrent developments include important work in the standardization of MRI-reporting. The low specificity and positive predictive value of MRI means that biopsy is still necessary following MRI.MRI-targeted prostate biopsy has emerged as an alternative diagnostic test to transrectal ultrasound guided prostate biopsy, though its exact role in biopsy naïve men and the optimal technique remain to be defined. Summary:There is the potential for MRI to be used as a triage test to allow a proportion of men to avoid biopsy and remain on PSA surveillance. MRI-suspicious areas can be sampled more intensively using MRI-targeted biopsy that can be carried out in a variety of ways. Future work should focus on the cost-effectiveness of introducing a pre-biopsy MRI pathway in biopsy naïve men and addressing the training needs for such a change.

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“…11,12 Recently, multiparametric magnetic resonance imaging (mpMRI), including diffusion-weighted imaging (DWI), has emerged as an important modality in prostate cancer diagnosis. [13][14][15] Several studies have identified the role of the apparent diffusion coefficient (ADC) value, obtained from DWI sequences, as a novel tool that may improve the diagnosis and management of prostatic cancer. These studies focused on the association between ADC value and GS.…”

Section: Introductionmentioning

confidence: 99%

Relationship between Gleason score and apparent diffusion coefficients of diffusion-weighted magnetic resonance imaging in prostate cancer patients

Kim¹,

Kim²,

Park³

et al. 2016

CUAJ

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Introduction:We assessed the correlation between the apparent diffusion coefficient (ADC) and pathological Gleason score (GS) of prostate cancer patients. Methods: A total of 125 patients who underwent multiparametric magnetic resonance imaging before radical prostatectomy for prostate cancer were included in this study. ADC values were compared with different GS. We used receiver operating characteristic analysis and determined the ADC cutoff value to differentiate tumours with a GS of 6 from those with a GS ≥7. Results: We identified 34 patients (27.2%) with a GS of 6; 33 patients (26.4%) with a GS of 7; 22 patients (17.6%) with a GS of 8; and 36 patients (28.8%) with a GS of ≥9. The mean ADC value for disease with a GS of 6 was 0.914 ± 0.161 x10 -3 mm 2 /s; GS of 7: 0.741 ± 0.164 x10 2 /s was the best cutoff value to identify prostate cancer with a GS of 6. Conclusions: We observed an inverse relationship between GS and ADC value. Moreover, a cutoff ADC value may help differentiate disease with a GS of 6 from disease with a GS ≥7.

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The role of magnetic resonance imaging in the diagnosis and management of prostate cancer

Cited by 136 publications

References 131 publications

Score 3 prostate lesions: a gray zone for PI-RADS v2

Score 3 prostate lesions: a gray zone for PI-RADS v2

The role of the multiparametric MRI in the diagnosis of prostate cancer in biopsy-naïve men

Relationship between Gleason score and apparent diffusion coefficients of diffusion-weighted magnetic resonance imaging in prostate cancer patients

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