UpToDate
Official reprint from UpToDate®
www.uptodate.com ©2016 UpToDate®

The role of magnetic resonance imaging in prostate cancer

Authors
Clare M C Tempany, MD
Peter Carroll, MD, MPH
Michael S Leapman, MD
Section Editors
Jerome P Richie, MD, FACS
Nicholas Vogelzang, MD
W Robert Lee, MD, MS, MEd
Deputy Editor
Michael E Ross, MD

INTRODUCTION

Prostate cancer will be diagnosed in approximately 181,000 men in the United States in 2016 and account for approximately 26,100 deaths [1]. Although widespread use of serum prostate specific antigen (PSA) screening of healthy men has resulted in decreases in cancer-related mortality, this benefit has been accompanied by increased detection and treatment of many cancers bearing low metastatic potential [2]. (See "Screening for prostate cancer", section on 'Prostate specific antigen (PSA)'.)

A priority in the management of the disease is the ability to accurately assess the presence of clinically significant lesions, the extent of disease at diagnosis, and to characterize the risk of future progression, thereby avoiding unnecessary treatment in men at low risk of progression.

Magnetic resonance imaging (MRI) offers increasingly reliable visualization of potentially significant prostate cancers and thus has shown advantages as a means by which to better select patients for biopsy and identify lesions for biopsy. MRI also provides information for staging the tumor extent and monitoring treatment response.

The technology of prostate MRI, the new prostate imaging reporting and data system (PI-RADS), and its current and potential clinical applications are reviewed in this topic.

TECHNOLOGY

Key advances that have contributed to the increased clinical utility of magnetic resonance imaging (MRI) of the prostate include the use of magnets with high field strength, the use of an endorectal coil, and the development of a novel set of imaging sequences that can be used in combination (so-called multiparametric MRI) to improve both lesion identification and characterization.

                 

Subscribers log in here

To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information or to purchase a personal subscription, click below on the option that best describes you:
Literature review current through: Nov 2016. | This topic last updated: Thu Sep 24 00:00:00 GMT+00:00 2015.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditions. The use of this website is governed by the UpToDate Terms of Use ©2016 UpToDate, Inc.
References
Top
  1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin 2016; 66:7.
  2. Schröder FH, Hugosson J, Roobol MJ, et al. Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet 2014; 384:2027.
  3. Steyn JH, Smith FW. Nuclear magnetic resonance imaging of the prostate. Br J Urol 1982; 54:726.
  4. Schnall MD, Lenkinski RE, Pollack HM, et al. Prostate: MR imaging with an endorectal surface coil. Radiology 1989; 172:570.
  5. Tempany CM, Zhou X, Zerhouni EA, et al. Staging of prostate cancer: results of Radiology Diagnostic Oncology Group project comparison of three MR imaging techniques. Radiology 1994; 192:47.
  6. Barentsz JO, Weinreb JC, Verma S, et al. Synopsis of the PI-RADS v2 Guidelines for Multiparametric Prostate Magnetic Resonance Imaging and Recommendations for Use. Eur Urol 2016; 69:41.
  7. Hegde JV, Mulkern RV, Panych LP, et al. Multiparametric MRI of prostate cancer: an update on state-of-the-art techniques and their performance in detecting and localizing prostate cancer. J Magn Reson Imaging 2013; 37:1035.
  8. Turkbey B, Shah VP, Pang Y, et al. Is apparent diffusion coefficient associated with clinical risk scores for prostate cancers that are visible on 3-T MR images? Radiology 2011; 258:488.
  9. Barentsz JO, Richenberg J, Clements R, et al. ESUR prostate MR guidelines 2012. Eur Radiol 2012; 22:746.
  10. Dickinson L, Ahmed HU, Allen C, et al. Magnetic resonance imaging for the detection, localisation, and characterisation of prostate cancer: recommendations from a European consensus meeting. Eur Urol 2011; 59:477.
  11. Hamoen EH, de Rooij M, Witjes JA, et al. Use of the Prostate Imaging Reporting and Data System (PI-RADS) for Prostate Cancer Detection with Multiparametric Magnetic Resonance Imaging: A Diagnostic Meta-analysis. Eur Urol 2015; 67:1112.
  12. Tempany CM, Rahmouni AD, Epstein JI, et al. Invasion of the neurovascular bundle by prostate cancer: evaluation with MR imaging. Radiology 1991; 181:107.
  13. Emberton M. Has magnetic resonance-guided biopsy of the prostate become the standard of care? Eur Urol 2013; 64:720.
  14. Grummet JP, Weerakoon M, Huang S, et al. Sepsis and 'superbugs': should we favour the transperineal over the transrectal approach for prostate biopsy? BJU Int 2014; 114:384.
  15. Sonn GA, Chang E, Natarajan S, et al. Value of targeted prostate biopsy using magnetic resonance-ultrasound fusion in men with prior negative biopsy and elevated prostate-specific antigen. Eur Urol 2014; 65:809.
  16. Hoeks CM, Schouten MG, Bomers JG, et al. Three-Tesla magnetic resonance-guided prostate biopsy in men with increased prostate-specific antigen and repeated, negative, random, systematic, transrectal ultrasound biopsies: detection of clinically significant prostate cancers. Eur Urol 2012; 62:902.
  17. Siddiqui MM, Rais-Bahrami S, Turkbey B, et al. Comparison of MR/ultrasound fusion-guided biopsy with ultrasound-guided biopsy for the diagnosis of prostate cancer. JAMA 2015; 313:390.
  18. Penzkofer T, Tuncali K, Fedorov A, et al. Transperineal in-bore 3-T MR imaging-guided prostate biopsy: a prospective clinical observational study. Radiology 2015; 274:170.
  19. Shakir NA, George AK, Siddiqui MM, et al. Identification of threshold prostate specific antigen levels to optimize the detection of clinically significant prostate cancer by magnetic resonance imaging/ultrasound fusion guided biopsy. J Urol 2014; 192:1642.
  20. Salami SS, Vira MA, Turkbey B, et al. Multiparametric magnetic resonance imaging outperforms the Prostate Cancer Prevention Trial risk calculator in predicting clinically significant prostate cancer. Cancer 2014; 120:2876.
  21. Panebianco V, Barchetti F, Sciarra A, et al. Multiparametric magnetic resonance imaging vs. standard care in men being evaluated for prostate cancer: a randomized study. Urol Oncol 2015; 33:17.e1.
  22. Eggener SE, Badani K, Barocas DA, et al. Gleason 6 Prostate Cancer: Translating Biology into Population Health. J Urol 2015; 194:626.
  23. http://www.nccn.org/professionals/physician_gls/pdf/prostate.pdf (Accessed on June 11, 2015).
  24. Rais-Bahrami S, Siddiqui MM, Turkbey B, et al. Utility of multiparametric magnetic resonance imaging suspicion levels for detecting prostate cancer. J Urol 2013; 190:1721.
  25. Komai Y, Numao N, Yoshida S, et al. High diagnostic ability of multiparametric magnetic resonance imaging to detect anterior prostate cancer missed by transrectal 12-core biopsy. J Urol 2013; 190:867.
  26. Volkin D, Turkbey B, Hoang AN, et al. Multiparametric magnetic resonance imaging (MRI) and subsequent MRI/ultrasonography fusion-guided biopsy increase the detection of anteriorly located prostate cancers. BJU Int 2014; 114:E43.
  27. Schimmöller L, Quentin M, Arsov C, et al. Predictive power of the ESUR scoring system for prostate cancer diagnosis verified with targeted MR-guided in-bore biopsy. Eur J Radiol 2014; 83:2103.
  28. Pokorny MR, de Rooij M, Duncan E, et al. Prospective study of diagnostic accuracy comparing prostate cancer detection by transrectal ultrasound-guided biopsy versus magnetic resonance (MR) imaging with subsequent MR-guided biopsy in men without previous prostate biopsies. Eur Urol 2014; 66:22.
  29. Somford DM, Hamoen EH, Fütterer JJ, et al. The predictive value of endorectal 3 Tesla multiparametric magnetic resonance imaging for extraprostatic extension in patients with low, intermediate and high risk prostate cancer. J Urol 2013; 190:1728.
  30. Heesakkers RA, Hövels AM, Jager GJ, et al. MRI with a lymph-node-specific contrast agent as an alternative to CT scan and lymph-node dissection in patients with prostate cancer: a prospective multicohort study. Lancet Oncol 2008; 9:850.
  31. Park BH, Jeon HG, Jeong BC, et al. Influence of magnetic resonance imaging in the decision to preserve or resect neurovascular bundles at robotic assisted laparoscopic radical prostatectomy. J Urol 2014; 192:82.
  32. Klotz L, Vesprini D, Sethukavalan P, et al. Long-term follow-up of a large active surveillance cohort of patients with prostate cancer. J Clin Oncol 2015; 33:272.
  33. Da Rosa MR, Milot L, Sugar L, et al. A prospective comparison of MRI-US fused targeted biopsy versus systematic ultrasound-guided biopsy for detecting clinically significant prostate cancer in patients on active surveillance. J Magn Reson Imaging 2015; 41:220.
  34. Schoots IG, Petrides N, Giganti F, et al. Magnetic resonance imaging in active surveillance of prostate cancer: a systematic review. Eur Urol 2015; 67:627.
  35. Stamatakis L, Siddiqui MM, Nix JW, et al. Accuracy of multiparametric magnetic resonance imaging in confirming eligibility for active surveillance for men with prostate cancer. Cancer 2013; 119:3359.
  36. Guo R, Cai L, Fan Y, et al. Magnetic resonance imaging on disease reclassification among active surveillance candidates with low-risk prostate cancer: a diagnostic meta-analysis. Prostate Cancer Prostatic Dis 2015; 18:221.
  37. Westphalen AC, Reed GD, Vinh PP, et al. Multiparametric 3T endorectal mri after external beam radiation therapy for prostate cancer. J Magn Reson Imaging 2012; 36:430.
  38. Pucar D, Shukla-Dave A, Hricak H, et al. Prostate cancer: correlation of MR imaging and MR spectroscopy with pathologic findings after radiation therapy-initial experience. Radiology 2005; 236:545.
  39. Arumainayagam N, Ahmed HU, Moore CM, et al. Multiparametric MR imaging for detection of clinically significant prostate cancer: a validation cohort study with transperineal template prostate mapping as the reference standard. Radiology 2013; 268:761.
  40. Donaldson IA, Alonzi R, Barratt D, et al. Focal therapy: patients, interventions, and outcomes--a report from a consensus meeting. Eur Urol 2015; 67:771.