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MRI of Prostate Cancer: Update

MRI of Prostate Cancer: Update Prostate cancer is the most frequently diagnosed cancer in men and the second leading cause of cancer-related death in men. The current standard in prostate cancer screening is the digital rectal examination and the prostate-specific antigen (PSA) test. This PSA test is nonspecific and may lead to both under- and overdiagnosis of prostate cancer. Therefore, despite PSA screening, there remains a major medical and socioeconomic impact due to morbidity and mortality from prostate cancer. Developing accurate diagnostic methods for individualized treatment of the disease is the current goal of researchers. In light of this aim, the collection of articles in this issue attempts to provide a comprehensive analysis of the clinical perspective and recent advances in diagnosing and guiding treatment of prostate cancer, specifically focusing on the use of magnetic resonance (MR) technology. Drs Patil and Gaitonde provide an excellent foundation for this review by examining screening and treatment methods for prostate cancer, specifically the markers and technology that have improved disease localization and detection. Earlier iterations of prostate MRI relied predominantly on morphologic and signal changes present on anatomic T1- and T2-weighted images and suffered from relatively poor sensitivity and specificity for detecting prostate cancer. Newer MRI sequences, including diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging (MRI), provide additional functional information about tissues and have enabled significant improvements in the ability of MRI to detect and characterize focal prostatic lesions. Current state-of-the-art prostate MRI consists of a multiparametric approach (mpMRI), in which 2 or more functional sequences complement the morphologic information provided by T2-weighted imaging. Substantial technical improvements in the ability to localize prostate cancer have been made using the mpMRI techniques. An excellent review on this subject is provided by Dr Bittencourt et al. This has led to greater use of MRI guidance for targeted prostate biopsy, which is an alternative to the current standard of transrectal ultrasonography (TRUS)-guided systematic biopsy. Clinical MRI-targeted biopsy approaches include an in-bore MR biopsy or MRI/ultrasound software fusion techniques. Included in this issue is a thorough review of strategies for interpretation and reporting of MRI results, the Prostate Imaging-Reporting and Data System (PIRADS) and in-bore MR guided systems by Futterer et al. Also included is a focused discussion by Margolis et al on the application of MR-TRUS fusion biopsy by targeting prostate cancer suspicious lesions on MRI, and a detailed examination by Turkbey et al regarding the usefulness of mpMRI in detecting recurrent prostate cancer in patients post-therapy. Vargas et al provide an important literature review that summarizes how MRI can be used to create a tailored management strategy for an individual patient. I am indebted to all authors for their extraordinary contributions of time and expertise, to Scott Atlas for his invitation to compile this issue, and to Stella Bebos and Samantha Martin at Wolters Kluwer for their invaluable editorial assistance. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Topics in Magnetic Resonance Imaging Wolters Kluwer Health

MRI of Prostate Cancer: Update

Verma, Sadhna
Topics in Magnetic Resonance Imaging , Volume 25 (3): 101 – Jun 1, 2016
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Copyright
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
Subject
Guest Editorial
ISSN
0899-3459
eISSN
1536-1004
DOI
10.1097/RMR.0000000000000092
pmid
27187166
Publisher site
See Article on Publisher Site

Abstract

Prostate cancer is the most frequently diagnosed cancer in men and the second leading cause of cancer-related death in men. The current standard in prostate cancer screening is the digital rectal examination and the prostate-specific antigen (PSA) test. This PSA test is nonspecific and may lead to both under- and overdiagnosis of prostate cancer. Therefore, despite PSA screening, there remains a major medical and socioeconomic impact due to morbidity and mortality from prostate cancer. Developing accurate diagnostic methods for individualized treatment of the disease is the current goal of researchers. In light of this aim, the collection of articles in this issue attempts to provide a comprehensive analysis of the clinical perspective and recent advances in diagnosing and guiding treatment of prostate cancer, specifically focusing on the use of magnetic resonance (MR) technology. Drs Patil and Gaitonde provide an excellent foundation for this review by examining screening and treatment methods for prostate cancer, specifically the markers and technology that have improved disease localization and detection. Earlier iterations of prostate MRI relied predominantly on morphologic and signal changes present on anatomic T1- and T2-weighted images and suffered from relatively poor sensitivity and specificity for detecting prostate cancer. Newer MRI sequences, including diffusion-weighted imaging and dynamic contrast-enhanced magnetic resonance imaging (MRI), provide additional functional information about tissues and have enabled significant improvements in the ability of MRI to detect and characterize focal prostatic lesions. Current state-of-the-art prostate MRI consists of a multiparametric approach (mpMRI), in which 2 or more functional sequences complement the morphologic information provided by T2-weighted imaging. Substantial technical improvements in the ability to localize prostate cancer have been made using the mpMRI techniques. An excellent review on this subject is provided by Dr Bittencourt et al. This has led to greater use of MRI guidance for targeted prostate biopsy, which is an alternative to the current standard of transrectal ultrasonography (TRUS)-guided systematic biopsy. Clinical MRI-targeted biopsy approaches include an in-bore MR biopsy or MRI/ultrasound software fusion techniques. Included in this issue is a thorough review of strategies for interpretation and reporting of MRI results, the Prostate Imaging-Reporting and Data System (PIRADS) and in-bore MR guided systems by Futterer et al. Also included is a focused discussion by Margolis et al on the application of MR-TRUS fusion biopsy by targeting prostate cancer suspicious lesions on MRI, and a detailed examination by Turkbey et al regarding the usefulness of mpMRI in detecting recurrent prostate cancer in patients post-therapy. Vargas et al provide an important literature review that summarizes how MRI can be used to create a tailored management strategy for an individual patient. I am indebted to all authors for their extraordinary contributions of time and expertise, to Scott Atlas for his invitation to compile this issue, and to Stella Bebos and Samantha Martin at Wolters Kluwer for their invaluable editorial assistance.

Journal

Topics in Magnetic Resonance Imaging – Wolters Kluwer Health

Published: Jun 1, 2016

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