Current Utilization and Acceptance of Multiparametric MRI in the Diagnosis of Prostate Cancer. A Regional Survey

Abstract

/2 11/8 11 77 54 Fax: ++ 49/2 11/8 11 61 45 lars.schimmoeller@med.uni-duesseldorf.de ABSTR AC TPurpose To assess the current regional acceptance, valuation, and clinical role of multiparametric MRI (mp-MRI) in prostate cancer diagnostics by patients and physicians. Materials and MethodsOf 482 distributed standardized questionnaires, 328 patient and 31 physician questionnaires (urological and general practitioners in and around Düssel-dorf) were analyzed over a period of 11 months. Questions were asked concerning general knowledge about prostate cancer, current diagnostic procedures, and knowledge about mp-MRI and MRI-guided biopsy.Results 70 % of the patients regarded accurate and exact diagnostics of prostate carcinomas as very important and 68 % considered MP-MRI a useful technique. 28 % of the patients with elevated PSA levels and negative transrectal ultrasound-guided biopsy (TRUS-GB) received MP-MRI as a secondary diagnostic. More than half of the patients estimated their overall knowledge about prostate cancer mediocre or worse and wished for more information about MR diagnostics. The majority of physicians (55 %) ordered MP-MRI studies of the prostate and 68 % saw their basic role in secondary diagnostics.Conclusion In this regional assessment mp-MRI of the prostate was considered useful by patients and practitioners. Currently, there still is a considerable discrepancy between recommended and the actual number of conducted MP-MRI studies, particularly in patients after previous negative TRUS-GB, although practitioners already see the benefit in this patient collective. Even though the use of prostate MRI is frequently more established than suggested in the current German S3-guideline, its full potential has not yet been exploited. More comprehensive information about the applications and diagnostic benefits of prostate MRI is needed and desired among patients and physicians.

Single center analysis of an advisable control interval for follow-up of patients with PI-RADS category 3 in multiparametric MRI of the prostate

“…A possible explanation for the relatively longer time intervals in patients without PCA until a PI-RADS downgrade was observed may be inflammatory changes due to granulomatous or non-bacterial prostatitis or atypical hyperplasia. As long as these diffuse changes persist, they can potentially still mask PCA lesions and therefore PI-RADS category 3 is still justified 27 – 29 .…”

Multiparametric magnetic resonance imaging can exclude prostate cancer progression in patients on active surveillance: a retrospective cohort study

“…Until today, data on serial mp-MRI using these standardized criteria in patients undergoing AS are lacking. Therefore, standardized mp-MRI-based monitoring of AS patients has not yet been implemented into current guidelines with exception of the UK National Institute for Clinical Excellence (NICE) guideline [14,22].…”

Prospective comparison of a fast 1.5‐T biparametric with the 3.0‐T multiparametric ESUR magnetic resonance imaging protocol as a triage test for men at risk of prostate cancer

“…So why are we not performing MRI before prostate biopsy more systematically? A survey has been conducted to understand the beliefs and practice patterns among urologists . Most respondents acknowledge the value of MRI and MRI‐targeted biopsy in clinical practice, but mentioned the lack of necessary infrastructure, the long waiting lists, and prohibitive costs as main factors limiting dissemination.…”

“…Although MRI of the prostate has been shown to improve the accuracy of prostate cancer (PCa) detection, its incorporation into the standard diagnostic care pathway remains rather slow . Lack of consensus on how to perform and read MRI, cost, lack of availability, and lack of prospective validations have been consistently cited as the main hurdles.…”