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World Journal of Urology

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Open Access 01-01-2022 | Prostate Cancer | Topic Paper

The utility of prostate MRI within active surveillance: description of the evidence

Authors: Georgina Dominique, Wayne G. Brisbane, Robert E. Reiter

Published in: World Journal of Urology | Issue 1/2022

Abstract

Purpose

We present an overview of the literature regarding the use of MRI in active surveillance of prostate cancer.

Methods

Both MEDLINE^® and Cochrane Library were queried up to May 2020 for studies of men on active surveillance with MRI and later confirmatory biopsy. The terms studied were ‘prostate cancer’ as the anchor followed by two of the following: active surveillance, surveillance, active monitoring, MRI, NMR, magnetic resonance imaging,  MRI, and multiparametric MRI. Studies were excluded if pathologic reclassification (GG1 → ≥ GG2) and PI-RADS or equivalent was not reported.

Results

Within active surveillance, baseline MRI is effective for identifying clinically significant prostate cancer and thus associated with fewer reclassification events. A positive initial MRI (≥ PI-RADS 3) with GG1 identified at biopsy has a positive predictive value (PPV) of 35–40% for reclassification by 3 years. MRI possessed a stronger negative predictive value, with a negative MRI (≤ PI-RADS 2) yielding a negative predictive value of up to 85% at 3 years. Surveillance MRI, obtained after initial biopsy, yielded a PPV of 11–65% and NPV of 85–95% for reclassification.

Conclusion

MRI is useful for initial risk stratification of prostate cancer in men on active surveillance, especially if MRI is negative when imaging is obtained during surveillance. While useful, MRI cannot replace biopsy and further research is necessary to fully integrate MRI into active surveillance.

Cooperberg MR, Carroll PR (2015) Trends in management for patients with localized prostate cancer, 1990–2013. JAMA 314(1):80–82. https://doi.org/10.1001/jama.2015.6036CrossRefPubMed

Siegel RL, Miller KD, Jemal A (2020) Cancer statistics, 2020. CA Cancer J Clin 70(1):7–30. https://doi.org/10.3322/caac.21590CrossRefPubMed

Klotz L et al (2015) Long-term follow-up of a large active surveillance cohort of patients with prostate cancer. J Clin Oncol 33(3):272–277. https://doi.org/10.1200/JCO.2014.55.1192CrossRefPubMed

Ahmed HU et al (2017) Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet 389(10071):815–822. https://doi.org/10.1016/S0140-6736(16)32401-1CrossRefPubMed

Mottet N et al (2017) EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: screening, diagnosis, and local treatment with curative intent. Eur Urol 71(4):618–629. https://doi.org/10.1016/j.eururo.2016.08.003CrossRefPubMed

NCCN Clinical Practice Guidelines (2018) Online. Available: https://www.nccn.org/store/login/login.aspx?ReturnURL=https://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf. Accessed 03 Jul 2020

Bjurlin MA et al (2020) Update of the standard operating procedure on the use of multiparametric magnetic resonance imaging for the diagnosis, staging and management of prostate cancer. J Urol 203(4):706–712. https://doi.org/10.1097/ju.0000000000000617CrossRefPubMed

Moore CM et al (2017) Reporting magnetic resonance imaging in men on active surveillance for prostate cancer: the PRECISE recommendations—a Report of a European School of Oncology Task Force. Eur Urol 71(4):648–655. https://doi.org/10.1016/j.eururo.2016.06.011CrossRefPubMed

Johnson DC, Reiter RE (2017) Multi-parametric magnetic resonance imaging as a management decision tool. Transl Androl Urol 6(3):472–482. https://doi.org/10.21037/tau.2017.05.22CrossRefPubMedPubMedCentral

10.

Moldovan PC et al (2017) What is the negative predictive value of multiparametric magnetic resonance imaging in excluding prostate cancer at biopsy? A systematic review and meta-analysis from the European Association of Urology Prostate Cancer Guidelines Panel. Eur Urol 72(2):250–266. https://doi.org/10.1016/j.eururo.2017.02.026CrossRefPubMed

11.

Brembilla G et al (2020) Interreader variability in prostate MRI reporting using Prostate Imaging Reporting and Data System version 2.1. Eur Radiol 30(6):3383–3392. https://doi.org/10.1007/s00330-019-06654-2CrossRefPubMed

12.

Atkins D et al (2004) Systems for grading the quality of evidence and the strength of recommendations I: critical appraisal of existing approaches. BMC Health Serv Res 4:1–7. https://doi.org/10.1186/1472-6963-4-38CrossRef

13.

Chamie K et al (2014) The role of magnetic resonance imaging in delineating clinically significant prostate cancer. Urology 83(2):369–375. https://doi.org/10.1016/j.urology.2013.09.045CrossRefPubMed

14.

Jayadevan R et al (2019) Magnetic resonance imaging-guided confirmatory biopsy for initiating active surveillance of prostate cancer. JAMA Netw open 2(9):e1911019. https://doi.org/10.1001/jamanetworkopen.2019.11019CrossRefPubMedPubMedCentral

15.

Klotz L et al (2020) Randomized Study of Systematic Biopsy Versus Magnetic Resonance Imaging and Targeted and Systematic Biopsy in Men on Active Surveillance (ASIST): 2-year Postbiopsy Follow-up. Eur Urol 77(3):311–317. https://doi.org/10.1016/j.eururo.2019.10.007CrossRefPubMed

16.

Newcomb LF et al (2016) Outcomes of active surveillance for clinically localized prostate cancer in the prospective, multi-institutional canary PASS cohort. J Urol 195(2):313–320. https://doi.org/10.1016/j.juro.2015.08.087CrossRefPubMed

17.

Tosoian JJ et al (2011) Active surveillance program for prostate cancer: an update of the Johns Hopkins experience. J Clin Oncol 29(16):2185–2190. https://doi.org/10.1200/JCO.2010.32.8112CrossRefPubMed

18.

Hamdy FC et al (2016) 10-year outcomes after monitoring, surgery, or radiotherapy for localized prostate cancer. N Engl J Med 375(15):1415–1424. https://doi.org/10.1056/NEJMoa1606220CrossRefPubMed

19.

Bokhorst LP et al (2016) A decade of active surveillance in the PRIAS Study: an update and evaluation of the criteria used to recommend a switch to active treatment. Eur Urol 70(6):954–960. https://doi.org/10.1016/j.eururo.2016.06.007CrossRefPubMed

20.

Johnson DC et al (2019) Detection of individual prostate cancer Foci via multiparametric magnetic resonance imaging. Eur Urol 75(5):712–720. https://doi.org/10.1016/j.eururo.2018.11.031CrossRefPubMed

21.

Kornberg Z et al (2019) Genomic Prostate Score, PI-RADS^TM version 2 and Progression in Men with Prostate Cancer on Active Surveillance. J Urol 201(2):300–306. https://doi.org/10.1016/j.juro.2018.08.047CrossRefPubMed

22.

Amin A et al (2020) The Magnetic Resonance Imaging in Active Surveillance (MRIAS) Trial: use of Baseline Multiparametric Magnetic Resonance Imaging and Saturation Biopsy to Reduce the Frequency of Surveillance Prostate Biopsies. J Urol 203(5):910–917. https://doi.org/10.1097/ju.0000000000000693CrossRefPubMed

23.

Halstuch D, Ber Y, Kedar D, Golan S, Baniel J, Margel D (2020) Short-term outcomes of active surveillance for low-risk prostate cancer among men with germline DNA repair gene mutations. J Urol. https://doi.org/10.1097/ju.0000000000001027CrossRefPubMed

24.

Gallagher KM et al (2019) Four-year outcomes from a multiparametric magnetic resonance imaging (MRI)-based active surveillance programme: PSA dynamics and serial MRI scans allow omission of protocol biopsies. BJU Int 123(3):429–438. https://doi.org/10.1111/bju.14513CrossRefPubMed

25.

Rais-Bahrami S et al (2014) Natural history of small index lesions suspicious for prostate cancer on multiparametric MRI: recommendations for interval imaging follow-up. Diagn Interv Radiol 20(4):293–298. https://doi.org/10.5152/dir.2014.13319CrossRefPubMedPubMedCentral

26.

Osses DF et al (2020) Prostate cancer upgrading with serial prostate magnetic resonance imaging and repeat biopsy in men on active surveillance: are confirmatory biopsies still necessary? BJU Int 126(1):124–132. https://doi.org/10.1111/bju.15065CrossRefPubMedPubMedCentral

27.

Chesnut GT et al (2020) Role of changes in magnetic resonance imaging or clinical stage in evaluation of disease progression for men with prostate cancer on active surveillance. Eur Urol 77(4):501–507. https://doi.org/10.1016/j.eururo.2019.12.009CrossRefPubMed

28.

Grimes DA, Schulz KF (2005) Refining clinical diagnosis with likelihood ratios. Lancet 365(9469):1500–1505. https://doi.org/10.1016/S0140-6736(05)66422-7CrossRefPubMed

29.

Felker ER et al (2016) Serial magnetic resonance imaging in active surveillance of prostate cancer: incremental value. J Urol 195(5):1421–1427. https://doi.org/10.1016/j.juro.2015.11.055CrossRefPubMed

30.

Shapiro DD et al (2020) Comparing confirmatory biopsy outcomes between MRI-targeted biopsy and standard systematic biopsy among men being enrolled in prostate cancer active surveillance. BJU Int. https://doi.org/10.1111/bju.15100CrossRefPubMed

31.

Cooperberg MR et al (2020) Tailoring intensity of active surveillance for low-risk prostate cancer based on individualized prediction of risk stability. JAMA Oncol 6:3187. https://doi.org/10.1001/jamaoncol.2020.3187CrossRef

32.

Pepe P, Dibenedetto G, Pepe L, Pennisi M (2020) Multiparametric MRI versus selecTMDX accuracy in the diagnosis of clinically significant PCA in men enrolled in active surveillance. In Vivo 34(1):393–396. https://doi.org/10.21873/invivo.11786CrossRefPubMedPubMedCentral

33.

Calculators—Canary PASS. Online. Available: https://canarypass.org/calculators/. Accessed 18 Sep 2020

34.

Nougaret S et al (2017) The performance of PI-RADSv2 and quantitative apparent diffusion coefficient for predicting confirmatory prostate biopsy findings in patients considered for active surveillance of prostate cancer. Abdom Radiol 42(7):1968–1974. https://doi.org/10.1007/s00261-017-1086-7CrossRef

Title: The utility of prostate MRI within active surveillance: description of the evidence
Authors: Georgina Dominique
Wayne G. Brisbane
Robert E. Reiter
Publication date: 01-01-2022
Publisher: Springer Berlin Heidelberg
Keywords: Prostate Cancer
Magnetic Resonance Imaging
Magnetic Resonance Imaging
Prostate Cancer
Published in: World Journal of Urology / Issue 1/2022
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-021-03853-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The utility of prostate MRI within active surveillance: description of the evidence

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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