MRI findings guiding selection of active surveillance for prostate cancer: a review of emerging evidence.

Content Provider	Europe PMC
Author	Glaser, Zachary A. Porter, Kristin K. Thomas, John V. Gordetsky, Jennifer B. Rais-Bahrami, Soroush
Copyright Year	2018
Abstract	Active surveillance (AS) for prostate cancer (PCa) is generally considered to be a safe strategy for men with low-risk, localized disease. However, as many as 1 in 4 patients may be incorrectly classified as AS-eligible using traditional inclusion criteria. The use of multiparametric magnetic resonance imaging (mpMRI) may offer improved risk stratification in both the initial diagnostic and disease monitoring setting. We performed a review of recently published studies to evaluate the utility of this imaging modality for this clinical setting. An English literature search was conducted on PubMed for original investigations on localized PCa, AS, and magnetic resonance imaging. Our Boolean criteria included the following terms: PCa, AS, imaging, MRI, mpMRI, prospective, retrospective, and comparative. Our search excluded publication types such as comments, editorials, guidelines, reviews, or interviews. Our literature review identified 71 original investigations. Among these, 52 met our inclusion criteria. Evidence suggests mpMRI improves characterization of clinically significant prostate cancer (csPCa) foci, and the enhanced detection and risk-stratification afforded by this modality may keep men from being inappropriately placed on AS. Use of serial mpMRI may also permit longer intervals between confirmatory biopsies. Multiple studies demonstrate the benefit of MRI-targeted biopsies. The use of mpMRI of the prostate offers improved confidence in risk-stratification for men with clinically low-risk PCa considering AS. While on AS, serial mpMRI and MRI-targeted biopsy aid in the detection of aggressive disease transformation or foci of clinically-significant cancer undetected on prior biopsy sessions.
Journal	Translational Andrology and Urology
Volume Number	7
PubMed Central reference number	PMC6178314
Issue Number	suppl 4
PubMed reference number	30363494
e-ISSN	22234691
DOI	10.21037/tau.2018.03.21
Language	English
Publisher	AME Publishing Company
Publisher Date	2018-09-01
Access Restriction	Open
Rights License	2018 Translational Andrology and Urology. All rights reserved.
Subject Keyword	Prostatic adenocarcinoma multiparametric magnetic resonance imaging (multiparametric MRI) cancer imaging cancer grading
Content Type	Text
Resource Type	Article
Subject	Reproductive Medicine Urology