Reply to Arnaldo Stanzione, Massimo Imbriaco, and Renato Cuocolo’s Letter to the Editor re: Marloes van der Leest, Bas Israël, Eric Bastiaan Cornel, et al. High Diagnostic Performance of Short Magnetic Resonance Imaging Protocols for Prostate Cancer Detection in Biopsy-naïve Men: The Next Step in Magnetic Resonance Imaging Accessibility. Eur Urol 2019;76:574–81. Are We Meeting Our Standards? Stringent Prostate Imaging Reporting and Data System Acquisition Requirements Might be Limiting Prostate Accessibility
Publication date: Available online 6 December 2019Source: European UrologyAuthor(s): Marloes van der Leest, Bas Israël, Rianne R.M. Engels, Jelle O. Barentsz
CONCLUSIONS: The integration of imaging and TB features drastically improves the intermediate risk sub-classification performance and better discriminates the unfavourable risk group that could benefit from more aggressive therapy such as neo-adjuvant and/or adjuvant treatment, and the favourable group that could avoid over-treatment. External validation in other datasets is needed. PMID: 31948932 [PubMed - as supplied by publisher]
In the November issue of Clinical Radiology, Richenberg offers an excellent insight into the creation and updating of the National Institute for Health and Care Excellence (NICE) guidance for prostate cancer.1 With the latest edition of this guideline, and the widespread use of magnetic resonance imaging (MRI) prior to prostate biopsy in the UK, it now falls on the radiologist to make an assessment of each patient's likelihood of harbouring prostate cancer. In essence, the radiologist has now become central to the decision for prostate biopsy.
Foley raises an interesting point about radiologists being responsible for the decision to biopsy patients undergoing magnetic resonance imaging (MRI) for suspicion of prostate cancer.1 Indeed, a key difference between the Likert system recommended in UK guidelines2,3 and the PI-RADS system, initially developed by the European Society of Urogenital Radiology (ESUR), is the ability to incorporate clinical information into the radiologists final report.4,5
DCE-MRI is established for detecting prostate cancer (PCa). However, it requires a gadolinium contrast agent, with potential risks for patients. The application of DIR-MRI is simple and may allow cancer detection without the use of an intravenous contrast agent by differentially nullifying signal from normal and abnormal prostate tissue, creating contrast between the cancer and background normal prostate. In this pilot study we gathered data from DIR-MRI and DCE-MRI of the prostate for an equivalence trial.
The objective of this study was to compare the prevalence of clinically significant prostate cancer (CSPCa) in men with biparametric prebiopsy prostate magnetic resonance imaging (MRI) and lesion-targeted biopsies (TBs) to the group of men without prebiopsy MRI in an initial biopsy session.Methods: The MRI group consists of men enrolled into four prospective clinical trials investigating a biparametric MRI (bpMRI) and TB while the non-MRI group was a retrospective cohort of men collected from an era prior to a clinical use of a prostate MRI. All men had standard biopsies (SBs). In the MRI group, men had additional TBs from...
A 60-year-old male has a medical history of prostate adenocarcinoma. He was treated in 2013 for an unfavorable intermediate-risk prostate cancer (Gleason score 4 + 3 = 7, prostate-specific antigen [PSA] 9.1, and T1c). Because of his unfavorable risk features, he underwent combined-modality treatment with external beam radiation therapy and prostate seed implantation. His PSA dropped to 0.20 (October 2015). His PSA trend is as follows: 0.88 (April 2016), 1.5 (March 2017), and 4.4 (January 2018). Multiparametric magnetic resonance imaging of the pelvis showed scattered multiple lymph nodes, measuring up ...
ConclusionsIn a large, single-institution, prospective AS cohort, the risk of cancer death or metastasis was
Condition: Metastatic Prostate Cancer Intervention: Radiation: MR-Guided Prostate SBRT Sponsor: Weill Medical College of Cornell University Not yet recruiting
ConclusionMpMRI is the primary modality for T-staging in hrPC as PET underestimated T-stage in direct comparison to final pathology. In this selected study, cohort MRI shows no inferiority compared to wbPET/MRI considering N-staging.