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MRI in active surveillance: a critical review

Prostate Cancer and Prostatic Diseases volume 22, pages 5–15 (2019)Cite this article

Subjects

Abstract

Introduction

Recent technological advancements and the introduction of modern anatomical and functional sequences have led to a growing role for multiparametric magnetic resonance imaging (mpMRI) in the detection, risk assessment and monitoring of early prostate cancer. This includes men who have been diagnosed with lower-risk prostate cancer and are looking at the option of active surveillance (AS). The purpose of this paper is to review the recent evidence supporting the use of mpMRI at different time points in AS, as well as to discuss some of its potential pitfalls.

Methods

A combination of electronic and manual searching methods were used to identify recent, important papers investigating the role of mpMRI in AS.

Results

The high negative predictive value of mpMRI can be exploited for the selection of AS candidates. In addition, mpMRI can be efficiently used to detect higher risk disease in patients already on surveillance.

Conclusion

Although there is an ongoing debate regarding the precise nature of its optimal implementation, mpMRI is a promising risk stratification tool and should be considered for men on AS.

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Acknowledgements

Francesco Giganti is funded by the University College London (UCL) Graduate Research Scholarship and the Brahm PhD scholarship in memory of Chris Adams. Mark Emberton is a United Kingdom National Institute of Health Research (NIHR) Senior Investigator. He receives research support from the UCLH/UCL NIHR Biomedical Research Centre. Caroline M Moore receives grant funding from Movember, Prostate Cancer UK, the National Institute for Health Research, the EAU Research Foundation and the Medical Research Council.

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Authors and Affiliations

  1. Division of Surgery and Interventional Science, University College London, Charles Bell House, 43-45 Foley Street, W1W 7TS, London, UK

    Vasilis Stavrinides, Francesco Giganti, Mark Emberton & Caroline M. Moore

  2. Department of Radiology, University College London Hospitals NHS Trust, 235 Euston Road, NW1 2BU, London, UK

    Francesco Giganti

  3. Department of Urology, University College London Hospitals NHS Trust, 235 Euston Road, NW1 2BU, London, UK

    Mark Emberton & Caroline M. Moore

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  1. Vasilis Stavrinides
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Correspondence to Vasilis Stavrinides.

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Stavrinides, V., Giganti, F., Emberton, M. et al. MRI in active surveillance: a critical review. Prostate Cancer Prostatic Dis 22, 5–15 (2019). https://doi.org/10.1038/s41391-018-0077-2

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