Multiparametric prostate MRI helps detect prostate cancer without biopsy

USA: A recent study published in the World Journal of Urology throws light on the use of multiparametric prostate MRI (mpMRI) for the management of prostate cancer.

According to the study, the incorporation of mpMRI of the prostate addresses the shortcomings of the prostate biopsy while providing several other advantages.

Multiparametric prostate magnetic resonance imaging(mpMRI) allows men to avoid an immediate biopsy and permits visualization of areas that are likely to harbor clinically significant cancer prior to biopsy to facilitate the use of MR-targeted prostate biopsies. This helps in improving detection and reducing the diagnosis of clinically insignificant disease, and better characterization of high-risk cancer. Also, it can be used for the selection and monitoring of patients for active surveillance and planning of treatment during focal therapy and surgery.

Magnetic resonance imaging (MRI) is a noninvasive test used to diagnose medical conditions.MRI uses a powerful magnetic field, radio waves and a computer to produce detailed pictures of internal body structures without using radiation (x-rays).

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Prostate cancer is diagnosed by 1) elevation in prostate-specific antigen or 2) abnormal exam leading to a systematic transrectal ultrasound (TRUS)-guided biopsy. However, this diagnostic pathway over-diagnose clinically insignificant disease while underdiagnosing the clinically significant disease. 

Multiparametric prostate magnetic resonance imaging consists of T2-weighted imaging (T2WI) combined with several functional sequences including diffusion-weighted imaging (DWI), perfusion or dynamic contrast-enhanced imaging (DCEI) and spectroscopic imaging. Recently, mp-MRI has been used to assess prostate cancer aggressiveness and to identify anteriorly located tumors before and during active surveillance.

Luke P. O'Connor, Urologic Oncology Branch, National Cancer Institute, NIH, Bethesda, MD, USA, and colleagues conducted this review to provide an overview of the recent literature regarding the role of multiparametric magnetic resonance imaging in the management of prostate cancer.

The researchers performed a thorough literature review using PubMed to identify articles that discussed the use of mpMRI of the prostate in the management of prostate cancer.

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The study, "Role of multiparametric prostate MRI in the management of prostate cancer," is published in the World Journal of Urology.

DOI: https://doi.org/10.1007/s00345-020-03310-z