Erratum to “Biparameteric prostate MRI and clinical indicators predict clinically significant prostate cancer in men with “gray zone” PSA levels” [Eur. J. Radiol. 127 (2020) 108977]

18 Background: Early-stage patients with prostate cancer can decide to go on Active Holistic Surveillance (AHS) to avoid over-treatment of a disease that has a high probability of being indolent. These patients are also placed on a special diet with vitamin supplements. We evaluate the imaging characteristics of this particular set of patients with prostate cancer with early-stage disease who are on a special diet and vitamin supplements, discontinued AHS and received definitive treatment. Methods: 300 consecutive 3T Multiparametric Prostate MRI (MP-MRI) were identified from March 26, 2012, to June 29, 2015. 200 patients (age 44 to 84 years) were identified in the active surveillance program. 114 patients had an initial MP-MRI prior to starting AHS and had at least one follow up MP-MRI after beginning AHS. 14 (12%) patients (age 60 to 79 years) discontinued AHS due to changes on a follow up MRI suggesting clinically significant prostate cancer. The MRI imaging findings were evaluated and correlated with pathology results, if available. Results: Of 14 patients, 3 (21%) patients had an enlarging MRI lesion compared to a previous MRI, 2 (14 %) patients had a new MRI lesion(s) suspicious for cancer, and 9 (64%) patients had suspicion or confirmation of extracapsular extension. 7 (50%) patients had a biopsy after a follow up MP-MRI with 6 (43%) demonstrating tumor upgrading. Length of time on AHS ranged from 4 months to 110 months. Prostate-specific antigen (PSA) levels and PSA density prior to beginning AHS ranged from 4.8 to 12.0 and 0.04 to 0.39, respectively. All were treated with definitive treatment, majority with unilateral focal cryoablation. Conclusions: The small number of patients with worsening disease on follow-up MP-MRI supports the role of AHS in patients with early-stage prostate cancer. MP-MRI is a useful tool in following patients on AHS and can extract patients who potentially may have clinically significant cancer and who may benefit from definitive treatment.

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Prostate Specific Antigen Density as a Predictor of Clinically Significant Prostate Cancer When the Prostate Specific Antigen is in the Diagnostic Gray Zone: Defining the Optimum Cutoff Point Stratified by Race and Body Mass Index

The Journal of Urology ◽

10.1016/j.juro.2018.05.016 ◽

2018 ◽

Vol 200 (4) ◽

pp. 758-766 ◽

Cited By ~ 10

Author(s):

Alireza Aminsharifi ◽

Lauren Howard ◽

Yuan Wu ◽

Amanda De Hoedt ◽

Charlotte Bailey ◽

...

Keyword(s):

Prostate Cancer ◽

Body Mass Index ◽

Prostate Specific Antigen ◽

Body Mass ◽

Specific Antigen ◽

Cutoff Point ◽

Gray Zone ◽

Prostate Specific Antigen Density ◽

Clinically Significant

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Incidental findings in and around the prostate on prostate MRI: a pictorial review

Insights into Imaging ◽

10.1186/s13244-021-00979-7 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Janki Trivedi ◽

Tom Sutherland ◽

Mark Page

Keyword(s):

Prostate Cancer ◽

Incidental Findings ◽

Diagnostic Modality ◽

Genitourinary System ◽

Prostate Mri ◽

Pictorial Review ◽

Life Saving ◽

Clinically Significant ◽

Mri Characteristics

AbstractProstate MRI has seen rapid growth in use in recent years as an advanced diagnostic modality to detect focal areas of clinically significant prostate cancer, to identify an area for targeted biopsy and to guide management and surveillance. The increase in use has also led to increased diagnosis of incidental lesions arising from structures around the prostate. These incidental findings may be related to the genitourinary system or non- genitourinary system and may have a benign aetiology which needs no additional follow-up, or it may require surveillance and management. The field of view in a multiparametric prostate MRI includes other pelvic organs, neurovascular bundles, bowel, lymph nodes and bones. Being familiar with standard MRI characteristics and a sound knowledge of anatomy of the prostate and surrounding structures can help in distinguishing normal anatomy from pathology. Given that patients undertaking a prostate MRI are usually a cohort with increased anxiety from their known or suspicion of prostate cancer, it is important that radiologists are familiar with these common incidental findings to minimise anxiety to the patient, have a well-informed discussion with the referring clinician and reduce costs associated with unnecessary further testing and follow-up of benign incidental findings. Additionally, being able to diagnose more serious incidental pathologies early can be life-saving and potentially significantly alter patient management.

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Multiparametric prostate MRI and structured reporting: benefits and challenges in the PI-RADS era

Chinese Journal of Academic Radiology ◽

10.1007/s42058-021-00059-1 ◽

2021 ◽

Vol 4 (1) ◽

pp. 21-40

Author(s):

Sanas Mir-Bashiri ◽

Kaneschka Yaqubi ◽

Piotr Woźnicki ◽

Niklas Westhoff ◽

Jost von Hardenberg ◽

...

Keyword(s):

Prostate Cancer ◽

Clinical Decision Making ◽

Imaging Modality ◽

Treatment Strategies ◽

High Sensitivity ◽

Clinical Decision ◽

Prostate Mri ◽

Radiology Reports ◽

Local Staging ◽

Clinically Significant

AbstractProstate cancer (PCa) is the second most frequent cancer diagnosis in men and the sixth leading cause of cancer death worldwide with increasing numbers globally. Therefore, differentiated diagnostic imaging and risk-adapted therapeutic approaches are warranted. Multiparametric magnetic resonance imaging (mpMRI) of the prostate supports the diagnosis of PCa and is currently the leading imaging modality for PCa detection, characterization, local staging and image-based therapy planning. Due to the combination of different MRI sequences including functional MRI methods such as diffusion-weighted imaging (DWI) and dynamic contrast-enhanced MRI (DCE-MRI), mpMRI enables a high sensitivity and specificity for the detection of PCa. The rising demand for individualized treatment strategies requires methods to ensure reproducibility, completeness, and quality of prostate MRI report data. The PI-RADS (Prostate Imaging Reporting and Data System) 2.1 classification represents the classification system that is internationally recommended for MRI-based evaluation of clinically significant prostate cancer. PI-RADS facilitates clinical decision-making by providing clear reporting parameters based on clinical evidence and expert consensus. Combined with software-based solutions, structured radiology reports form the backbone to integrate results from radiomics analyses or AI-applications into radiological reports and vice versa. This review provides an overview of imaging methods for PCa detection and local staging while placing special emphasis on mpMRI of the prostate. Furthermore, the article highlights the benefits of software-based structured PCa reporting solutions implementing PI-RADS 2.1 for the integration of structured data into decision support systems, thereby paving the way for workflow automation in radiology.

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