Journal
CURRENT OPINION IN UROLOGY
Volume 24, Issue 3, Pages 280-287Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOU.0000000000000040
Keywords
active surveillance; MRI; prostate cancer; radiological phenotype
Categories
Funding
- Department of Health's NIHR Biomedical Research Centres [96]
- Medical Research Council (UK)
- Bob Champion Trust
- Pelican Cancer Foundation charity
- Prostate Cancer UK
- St Peters Trust charity
- Prostate Cancer Research Centre
- Wellcome Trust
- National Institute of Health Research-Health Technology Assessment program
- US National Institutes of Health National Cancer Institute Movember
- UCLH Charitable Trustees
- Department of Health
- Movember
- National Institute for Health Research [09/22/67] Funding Source: researchfish
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Purpose of reviewThe role of MRI in active surveillance to date has been in assessing men with low or intermediate-risk disease to identify those men harbouring higher risk disease undersampled at standard biopsy. MRI as a tool for reassessing men over the surveillance period, as an alternative to repeat standard biopsies, is also of interest.Recent findingsMultiple studies suggest that MRI early in active surveillance can identify men whose prostate cancer was undersampled at initial biopsy, and MRI-targeted biopsies can be offered. There are a small number of centres now using MRI in the routine follow-up of men on active surveillance. The presence of a lesion on MRI indicates that a man is at higher likelihood of radiological progression than men with a negative MRI at diagnosis. These findings need to be validated in longer-term studies with predefined criteria for radiological significance and radiological progression.SummaryMRI is useful in the identification of men with higher-risk prostate cancer prior to commencement of a formal active surveillance programme. It is also of use in following up men on active surveillance, as a way to detect change in tumour over time.
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