Who Benefits from Multiparametric Magnetic Resonance Imaging After Suspicion of Prostate Cancer?

Moróte, Juan; Celma, A.; Roche, S.; Torres, Inés M. de; Mast, Richard; Semedey, Maria E.; Regis, Lucas; Planas, Jacques

doi:10.1016/j.euo.2018.11.009

Cited by 24 publications

(28 citation statements)

References 21 publications

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“…The PI-RADS steering committee acknowledges the considerable challenge presented by implementation of multiparametric MRI and MRI-directed biopsies for most men suspected of having clinically significant prostate cancer. We acknowledge that not all patients suspected of having cancer benefit from the multiparametric MRI approach because clinical studies have largely excluded men with clinically obvious locally advanced disease with a markedly elevated PSA level (80). Furthermore, we realize that the results of studies undertaken in high-volume expert centers, with the advantages of state-of-the-art equipment, optimized protocols, and highly experienced subspecialized radiologists, may not be applicable to clinical practice everywhere.…”

Section: Delivering Benefits To Patientsmentioning

confidence: 99%

PI-RADS Steering Committee: The PI-RADS Multiparametric MRI and MRI-directed Biopsy Pathway

Padhani¹,

Barentsz²,

Villeirs³

et al. 2019

Radiology

171

118

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he current version of the Prostate Imaging Reporting and Data System (PI-RADS) was formulated on experience gained from PI-RADS version 1, accumulated scientific evidence, and expert consensus (1). The release of PI-RADS version 2.1 is expected to further improve observer variability (2). A recent publication evaluated multiple clinical studies, systematic analyses, and professional guidelines on their use of multiparametric MRI in prostate cancer detection (3). It showed that the test performance of multiparametric MRI-directed biopsy in the detection of prostate cancer is superior to that of systematic transrectal US-guided biopsy. High-level evidence has now established multiple benefits of MRI-directed biopsy over systematic transrectal US-guided biopsy of the prostate (4). These benefits include (a) a reduction in the number of men who need to undergo biopsy (5-9); (b) a reduction in the number of diagnoses of clinically insignificant cancers that are unlikely to cause harm (4,10), with the potential to reduce overtreatment, treatment-related complications, and active surveillance rates (6); (c) improved detection of clinically significant prostate cancers, particularly in patients with prior negative transrectal US-guided biopsy findings (4,10); and (d) improved risk stratification of diagnosed cancers owing to greater precision in tumor grade and volume determinations, which helps direct disease management. All these advantages can be achieved with fewer targeted biopsy cores per patient, potentially reducing biopsy-related morbidity (6,8,11). The purpose of this article is to focus on how multiparametric MRI results can positively impact the health of men suspected of having clinically significant prostate cancer. Who Should Undergo MRI before Biopsy? Patients chosen for MRI before biopsy include biopsynaive men with elevated serum prostate-specific antigen (PSA) levels, abnormal digital rectal examination findings, or both, and men who are deemed to have persistent elevated risk of harboring clinically significant cancers despite prior negative or nonexplanatory systematic transrectal US biopsy findings. Indications for MRI should be based on the recommendations for screening and early diagnosis of the National Comprehensive Cancer Network and the European Association of Urology (12,13). Accordingly, biopsy-naive men with lower than average risk of prostate cancer should not undergo prostate biopsy or MRI. However, limiting the options to prespecified PSA thresholds is not recommended, as there are many factors (eg, symptoms, age, race, family history, PSA kinetics, digital rectal examination findings) that in

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Section: Delivering Benefits To Patientsmentioning

confidence: 99%

PI-RADS Steering Committee: The PI-RADS Multiparametric MRI and MRI-directed Biopsy Pathway

Padhani¹,

Barentsz²,

Villeirs³

et al. 2019

Radiology

171

118

View full text Add to dashboard Cite

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“…There are men who are highly likely to have prostate cancer based on very elevated serum PSA levels accompanied by abnormal digital rectal examinations. These men are unlikely to derive clinical benefits from DCE 44 . These men may be more accepting of delays in detecting small cancers (ISUP 1-2) that are unlikely to cause harm in the short term.…”

Section: Bpmri Use For Prostate Cancer Diagnosismentioning

confidence: 99%

Contrast Medium or No Contrast Medium for Prostate Cancer Diagnosis. That Is the Question

Padhani

Schoots

Villeirs

2020

Magnetic Resonance Imaging

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“…In patients with PSA levels above 10 ng/mL and positive DRE, mpMRI brings a negligible benefit for diagnosing PCa. In general, mpMRI could reduce the number of unnecessary biopsies by 25% and increase the identification of High Grade (HG) PCa by up to 28% [ 61 ].…”

Section: Imagistic Techniquesmentioning

confidence: 99%

PSA Based Biomarkers, Imagistic Techniques and Combined Tests for a Better Diagnostic of Localized Prostate Cancer

Munteanu

Gulei

et al. 2020

Diagnostics

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Prostate cancer represents the most encountered urinary malignancy in males over 50 years old, and the second most diagnosed after lung cancer globally. Digital rectal examination and prostatic specific antigen were the long-time standard tools for diagnosis but with a significant risk of overdiagnosis and overtreatment. Magnetic resonance imaging recently entered the diagnosis process, but to this date, there is no specific biomarker that accurately indicates whether to proceed with the prostate biopsy. Research in this area has gone towards this direction, and recently, serum, urine, imagistic, tissue biomarkers, and Risk Calculators promise to help better diagnose and stratify prostate cancer. In order to eliminate the comorbidities that appear along with the diagnosis and treatment of this disease, there is a constant need to implement new diagnostic strategies. Important uro-oncology associations recommend the use of novel biomarkers in the grey area of prostate cancer, to better distinguish the next step in the diagnostic process. Although it is not that simple, they should be integrated according to the clinical policies, and it should be considered that statistical significance does not always equal clinical significance. In this review, we analyzed the contribution of prostate-specific antigen (PSA)-based biomarkers (PHI, PHID, 4Kscore, STHLM3), imagistic techniques (mp-MRI and mp-US), and combined tests in the early diagnosis process of localized prostate cancer.

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Who Benefits from Multiparametric Magnetic Resonance Imaging After Suspicion of Prostate Cancer?

Cited by 24 publications

References 21 publications

PI-RADS Steering Committee: The PI-RADS Multiparametric MRI and MRI-directed Biopsy Pathway

PI-RADS Steering Committee: The PI-RADS Multiparametric MRI and MRI-directed Biopsy Pathway

Contrast Medium or No Contrast Medium for Prostate Cancer Diagnosis. That Is the Question

PSA Based Biomarkers, Imagistic Techniques and Combined Tests for a Better Diagnostic of Localized Prostate Cancer

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