Multiparametric magnetic resonance imaging vs. standard care in men being evaluated for prostate cancer: A randomized study

Panebianco, Valeria; Barchetti, Flavio; Sciarra, Alessandro; Ciardi, Antonio; Indino, Elena Lucia; Papalia, Rocco; Gallucci, Michele; Tombolini, Vincenzo; Gentile, Vincenzo; Catalano, Carlo

doi:10.1016/j.urolonc.2014.09.013

Cited by 206 publications

(154 citation statements)

References 20 publications

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“…However this benefit was restricted to the repeat biopsy subgroup [32]. Three more recent RCTs restricted to the initial biopsy, yielded contradictory results regarding the added value of MRI-Tbx combined with systematic biopsies [33,34]. Major limitations of mpMRI are its inter-observer variability and the heterogeneity in definitions of positive and negative examinations.…”

Section: Prostate Biopsymentioning

confidence: 99%

EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent

et al. 2017

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Section: Prostate Biopsymentioning

confidence: 99%

EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent

et al. 2017

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“…In summary, mpMRI could be useful in AS through (i) identifying men who would most benefit from additional biopsy (as presence of suspicious lesions on MRI predicts unfavorable histology [50]), (ii) increasing the diagnostic accuracy of prostate biopsy (as MRI-targeted biopsies in MRI-positive men increase the detection of significant cancers [51], outperform standard biopsies [52,53] and reduce misclassification [54]), (iii) reducing the number of biopsies needed to diagnose significant cancer [55] and the need for repeat biopsies [56] …”

Section: Mri In Active Surveillancementioning

confidence: 99%

When no treatment is the best treatment: Active surveillance strategies for low risk prostate cancers

Stavrinides

Parker

Moore

2017

Cancer Treatment Reviews

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Title:When no treatment is the best treatment: active surveillance strategies for low risk prostate cancers. Abstract:Although the incidence of prostate cancer is rising due to PSA screening and increased life expectancy, the metastatic potential of low-grade, organ-confined disease remainslow. An increasing number of studies suggest that radical treatment in such cases confers little or no survival benefit at a significant cost to morbidity. Active surveillance is a promising management approach of such low-risk cancers: eligible patients are selected based on clinical and pathological findings at diagnosis and are regularly monitored with digital rectal examinations, PSA testing and biopsies. Treatment, however, is deferred until and unless there is evidence of disease progression. This is a key difference from watchful waiting, where treatment is avoided until and unless there are symptoms. The purpose of this work is to review the rationale and evidence behind active surveillance and to offer an overview of current active surveillance strategies and outcomes.

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“…Furthermore, when a lesion is seen, mpMRI can provide insight regarding tumor behavior. 56,57 For instance, mpMRI has been used to predict Gleason scores mainly through apparent diffusion coefficient (ADC) values derived from diffusion-weighted MRI. Although there are strong inverse correlations between ADC and Gleason grade, mpMRI cannot at this time be considered a replacement for biopsy.…”

Section: Multiparametric Mri In Active Surveillancementioning

confidence: 99%

Active Surveillance of Prostate Cancer: Use, Outcomes, Imaging, and Diagnostic Tools

Tosoian¹,

Loeb²,

Epstein³

et al. 2016

American Society of Clinical Oncology Educational Book

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Active surveillance (AS) has emerged as a standard management option for men with very low-risk and low-risk prostate cancer, and contemporary data indicate that use of AS is increasing in the United States and abroad. In the favorable-risk population, reports from multiple prospective cohorts indicate a less than 1% likelihood of metastatic disease and prostate cancer-specific mortality over intermediate-term follow-up (median 5 to 6 years). Higher-risk men participating in AS appear to be at increased risk of adverse outcomes, but these populations have not been adequately studied to this point. Although monitoring on AS largely relies on serial prostate biopsy, a procedure associated with significant morbidity, there is a need for improved diagnostic tools for patient selection and monitoring. Revisions from the 2014 International Society of Urologic Pathology consensus conference have yielded a more intuitive reporting system and detailed reporting of low-intermediate grade tumors, which should facilitate the practice of AS. Meanwhile, emerging modalities such as multiparametric magnetic resonance imaging and tissue-based molecular testing have shown prognostic value in some populations. At this time, however, these instruments have not been sufficiently studied to consider their routine, standardized use in the AS setting. Future studies should seek to identify those platforms most informative in the AS population and propose a strategy by which promising diagnostic tools can be safely and efficiently incorporated into clinical practice.

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Multiparametric magnetic resonance imaging vs. standard care in men being evaluated for prostate cancer: A randomized study

Cited by 206 publications

References 20 publications

EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent

EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent

When no treatment is the best treatment: Active surveillance strategies for low risk prostate cancers

Active Surveillance of Prostate Cancer: Use, Outcomes, Imaging, and Diagnostic Tools

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