PURPOSE OF REVIEW: The current challenge in prostate cancer diagnosis is how to accurately measure the risk of disease progression and guide the treatment decision process between effective intervention for potentially harmful tumors and active surveillance for indolent disease.
The issue is how to better identify patients harboring insignificant disease using the current diagnosis pathway based on 12-core systematic biopsy, which misclassifies tumor volume and/or grade in up to 30% of cases. Integrating MRI into the diagnosis process may help to better determine if the cancer is at very low risk of disease progression, i.e. clinically indolent or insignificant.
RECENT FINDINGS: Recent advances in prostate imaging techniques suggest that multiparametric MRI has a high negative predictive value (up to 95%) in ruling out clinically significant prostate cancer and may potentially have clinical use in diagnostic pathways in men at risk for prostate cancer. Prospective studies should be performed to examine the rate of reclassification using MRI-targeted biopsy in patients potentially eligible for active surveillance based on current tests (12-cores systematics biopsies).
SUMMARY: Patients with nonsuspicious multiparametric MRI represent a special very low-risk group of men with either no disease or clinically insignificant disease, allowing them to be managed conservatively.
Written by:
Ouzzane A, Puech P, Villers A. Are you the author?
Department of Urology bDepartment of Radiology, CHU Lille, Univ Lille Nord de France, Lille cInserm U703, CHRU Lille, Univ Lille Nord de France, Loos, France.
Reference: Curr Opin Urol. 2014 May;24(3):264-9.
doi: 10.1097/MOU.0000000000000047
PubMed Abstract
PMID: 24625426
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