Prostate MRI Was Negative-What's Next?
| Autor: | Seibert TM; Department of Radiation Medicine and Applied Sciences, UC San Diego School of Medicine, La Jolla, California.; Department of Radiology, UC San Diego School of Medicine, La Jolla, California.; Department of Bioengineering, UC San Diego Jacobs School of Engineering, La Jolla, California. |
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| Jazyk: | angličtina |
| Zdroj: | Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology [Cancer Epidemiol Biomarkers Prev] 2024 May 01; Vol. 33 (5), pp. 641-642. |
| DOI: | 10.1158/1055-9965.EPI-24-0214 |
| Abstrakt: | The primary benefit of prostate MRI in the modern diagnostic pathway for prostate cancer is that many men with elevated serum PSA can safely avoid an immediate biopsy if the MRI is nonsuspicious. It is less clear, though, how these patients should be followed thereafter. Are they to be followed the same as the general population, or do they warrant more attention because of the risk of a cancer missed on MRI? In this issue, Pylväläinen and colleagues report on incidence of clinically significant prostate cancer (csPCa) and clinically insignificant PCa (ciPCa) among patients who were referred for prostate MRI for clinical suspicion of csPCa in Helsinki but had a nonsuspicious MRI (nMRI). Compared with the general population in Finland, patients who had nMRI were approximately 3.4 times more likely to be diagnosed with csPCa and 8.2 times more likely to be diagnosed with ciPCa. Balancing the competing risks of a missed csPCa versus overdiagnosis in patients after nMRI requires integration of MRI and other risk factors, especially age and PSA density. This integration may be facilitated by multivariable models and quantitative pathology and imaging. See related article by Pylväläinen et al., p. 749. (©2024 American Association for Cancer Research.) |
| Databáze: | MEDLINE |
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