Is MRI ready to replace biopsy during active surveillance?

Autor: Dias AB; University Medical Imaging Toronto; Joint Department of Medical Imaging; University Health Network-Sinai Health System-Women's College Hospital, University of Toronto, Toronto, ON, Canada., Woo S; Department of Radiology, NYU Langone Health, New York, NY, USA., Leni R; Division of Experimental Oncology, Department of Urology, IRCCS San Raffaele Scientific Institute, Milan, Italy.; Vita-Salute San Raffaele University, Milan, Italy., Rajwa P; Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.; Department of Urology, Medical University of Silesia, Zabrze, Poland., Kasivisvanathan V; Division of Surgery & Interventional Science, University College London, London, UK; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK., Ghai S; University Medical Imaging Toronto; Joint Department of Medical Imaging; University Health Network-Sinai Health System-Women's College Hospital, University of Toronto, Toronto, ON, Canada., Haider M; University Medical Imaging Toronto; Joint Department of Medical Imaging; University Health Network-Sinai Health System-Women's College Hospital, University of Toronto, Toronto, ON, Canada., Gandaglia G; Division of Experimental Oncology, Department of Urology, IRCCS San Raffaele Scientific Institute, Milan, Italy.; Vita-Salute San Raffaele University, Milan, Italy., Brembilla G; Vita-Salute San Raffaele University, Milan, Italy. brembilla.giorgio@hsr.it.; Department of Radiology, IRCCS San Raffaele Scientific Institute, Milan, Italy. brembilla.giorgio@hsr.it.
Jazyk: angličtina
Zdroj: European radiology [Eur Radiol] 2024 Dec; Vol. 34 (12), pp. 7716-7727. Date of Electronic Publication: 2024 Jul 04.
DOI: 10.1007/s00330-024-10863-9
Abstrakt: Active surveillance (AS) is a conservative management option recommended for patients diagnosed with low-risk prostate cancer (PCa) and selected cases with intermediate-risk PCa. The adoption of prostate MRI in the primary diagnostic setting has sparked interest in its application during AS. This review aims to examine the role and performance of multiparametric MRI (mpMRI) across the entire AS pathway, from initial stratification to follow-up, also relative to the utilization of the Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) criteria. Given the high negative predictive value of mpMRI in detecting clinically significant PCa (csPCa), robust evidence supports its use in patient selection and risk stratification at the time of diagnosis or confirmatory biopsy. However, conflicting results have been observed when using MRI in evaluating disease progression during follow-up. Key areas requiring clarification include addressing the clinical significance of MRI-negative csPCa, optimizing MRI quality, determining the role of biparametric MRI (bpMRI) or mpMRI protocols, and integrating artificial intelligence (AI) for improved performance. CLINICAL RELEVANCE STATEMENT: MRI plays an essential role in the selection, stratification, and follow up of patients in active surveillance (AS) for prostate cancer. However, owing to existing limitations, it cannot fully replace biopsies in the context of AS. KEY POINTS: Multiparametric MRI (mpMRI) has become a crucial tool in active surveillance (AS) for prostate cancer (PCa). Conflicting results have been observed regarding multiparametric MRI efficacy in assessing disease progression. Standardizing MRI-guided protocols will be critical in addressing current limitations in active surveillance for prostate cancer.
Competing Interests: Compliance with ethical standards Guarantor The scientific guarantor of this publication is Giorgio Brembilla. Conflict of interest The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. Statistics and biometry No complex statistical methods were necessary for this paper. Informed consent Written informed consent was not required. Ethical approval Institutional Review Board approval was not required. Study subjects or cohorts overlap Not applicable. Methodology Invited review
(© 2024. The Author(s), under exclusive licence to European Society of Radiology.)
Databáze: MEDLINE
Externí odkaz: