Impact of Multiparametric MRI and PSA Density on the Initial Indication or the Maintaining in Active Surveillance During Follow-Up in low-Risk Prostate Cancer

Prospective Implementation and Early Outcomes of a Risk-stratified Prostate Cancer Active Surveillance Follow-up Protocol

“…Studies have shown that in AS, it is a useful predictor of biopsy upgrading, aids MRI in predicting early reclassification, and informs repeat biopsy interval [35] , [36] , [37] . Remarkably, both our work and others’ works have demonstrated the key threshold of PSAd of ≥0.15 in differentiating future behaviour [11] , [38] , [39] . MRI is now an indispensable aspect of AS management, with some advocating that it can even replace biopsy in future [40] .…”

Aggressive Prostate Cancer in Patients Treated with Active Surveillance

“…On the other hand, MRI has improved the visualization of lesions, such as the anterior prostate [62], and has reduced sampling errors and underdiagnoses during systematic biopsies. In fact, when prostate cancer is diagnosed by an MRI-fusion biopsy and AS is initiated, the rate of discontinuation of AS has been reported to be reduced [63]. Huang et al, evaluated the association between the apparent diffusion coefficient (ADC) values on initial multiparametric MRI (mpMRI) and biopsy grade reclassification to Gleason grade group ≥2 in men on AS with Gleason grade group 1 PC.…”