Magnetic Resonance–invisible Versus Magnetic Resonance–visible Prostate Cancer in Active Surveillance: A Preliminary Report on Disease Outcomes

Dianat, Seyed Saeid; Carter, H. Ballentine; Pienta, Kenneth J.; Schaeffer, Edward M.; Landis, Patricia; Epstein, Jonathan I.; Trock, Bruce J.; Macura, Katarzyna J.

doi:10.1016/j.urology.2014.06.085

Cited by 54 publications

(33 citation statements)

References 16 publications

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“…For men with newly diagnosed PCa, the presence of MRI-discernable lesions has been suggested as an adverse prognostic characteristic particularly for men initiating management with AS, where retrospective studies have suggested an increased risk for disease Association of MRI and genomic profiling in men with prostate cancer reclassification due to changes in tumor volume estimates [22]. As MRI studies incorporate multiple sequences believed to reflect anatomic, tumor vascularity, and cellularity it is not known whether higher rates of upgrading reflect improved sampling associated with larger tumors in some men or the occurrence of genuine biological progression.…”

Section: Discussionmentioning

confidence: 99%

Association between a 17-gene genomic prostate score and multiparametric prostate MRI in men with low- and intermediate-risk prostate cancer (PCa).

Leapman

Westphalen

Ameli

et al. 2015

JCO

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Section: Discussionmentioning

confidence: 99%

Association between a 17-gene genomic prostate score and multiparametric prostate MRI in men with low- and intermediate-risk prostate cancer (PCa).

Leapman

Westphalen

Ameli

et al. 2015

JCO

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“…Some more recent studies that had not been included in this meta-analysis have confirmed these results. [11][12][13][14][15] One evaluated 392 patients on AS, with the absence of a focal/dominant lesion on baseline multiparametric MRI documented in 208 (53.1%) cases. 11 Of those, 193 (93%) did not have high-grade cancer on confirmatory biopsy.…”

Section: The Significance Of a ''Negative'' Prostate Mrimentioning

confidence: 99%

“…In a study of 96 patients on AS, of those with a negative base-line MRI (n ¼ 12), only 1 patient was found to have adverse pathology on confirmatory biopsy. 12 In another study, DWI-MR images from 117 potential AS candidates were rated on a 5-point Likert scale and the negative predictive value of a score 2 or less was 96.5%. 13 Another group sequentially performed transrectal prostate biopsy, multiparametric prostate MRI (ie, T2-weighted imaging, DWI, and DCE), as well as template-guided prostate mapping biopsy with a median of 48 cores in 194 patients with low-risk PCa.…”

Section: The Significance Of a ''Negative'' Prostate Mrimentioning

confidence: 99%

Role of MRI in the Risk Assessment of Primary Prostate Cancer

Wibmer

Verma²,

Vargas³

2016

Topics in Magnetic Resonance Imaging

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A successful paradigm shift toward personalized management strategies for patients with prostate cancer (PCa) is heavily dependent on the availability of noninvasive diagnostic tools capable of accurately establishing the true extent of disease at the time of diagnosis and estimating the risk of subsequent disease progression and related mortality. Although there is still considerable scope for improvement in its diagnostic, predictive, and prognostic capabilities, multiparametric prostate magnetic resonance imaging (MRI) is currently regarded as the imaging modality of choice for local staging of PCa. A negative MRI, that is, the absence of any MRI-visible intraprostatic lesion, has a high negative predictive value for the presence of clinically significant PCa and can substantiate the consideration of active surveillance as a preferred initial management approach. MRI-derived quantitative and semi-quantitative parameters can be utilized to noninvasively characterize MRI-visible prostate lesions and identify those patients who are most likely to benefit from radical treatment, and differentiate them from patients with benign or indolent prostate pathology that may also be visible on MRI. This literature review summarizes current strategies how MRI can be used to determine a tailored management strategy for an individual patient.

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“…In patients diagnosed with low risk prostate cancer as detected by TRUS-guided biopsy, mpMRI can be used to identify those patients who may actually have higher risk/grade disease and thus, would be inappropriate candidates for active surveillance [31,32]. Tumors that are not visible or are of low suspicion on mpMRI are less likely to have adverse pathology [33][34][35][36].…”

Section: The Role Of Mpmri In Risk Stratificationmentioning

confidence: 99%

Integration of Multiparametric MRI Into Active Surveillance of Prostate Cancer

et al. 2016

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Prostate cancer is the most common noncutaneous cancer in men though many men will not die of this disease and may not require definitive treatment. Active surveillance (AS) is an increasingly utilized potential solution to the issue of overtreatment of prostate cancer. Traditionally, prostate cancer patients have been stratified into risk groups based on clinical stage on digital rectal examination, prostate-specific antigen and biopsy Gleason score, though each of these variables has significant limitations. This review will discuss the potential role for prostate multiparametric MRI and targeted biopsy techniques incorporating MRI in the selection of candidates for AS, monitoring patients on AS and as triggers for definitive treatment.

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Magnetic Resonance–invisible Versus Magnetic Resonance–visible Prostate Cancer in Active Surveillance: A Preliminary Report on Disease Outcomes

Cited by 54 publications

References 16 publications

Association between a 17-gene genomic prostate score and multiparametric prostate MRI in men with low- and intermediate-risk prostate cancer (PCa).

Association between a 17-gene genomic prostate score and multiparametric prostate MRI in men with low- and intermediate-risk prostate cancer (PCa).

Role of MRI in the Risk Assessment of Primary Prostate Cancer

Integration of Multiparametric MRI Into Active Surveillance of Prostate Cancer

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