Giganti, F; Kirkham, A; Allen, C; Punwani, S; Orczyk, C; Emberton, M; Moore, CM; (2020) Update on multiparametric prostate MRI during active surveillance: current and future trends and role of the PRECISE recommendations. American Journal of Roentgenology 10.2214/AJR.20.23985. (In press).

Text Giganti_Update on multiparametric prostate MRI during active surveillance- current and future trends and role of the PRECISE recommendations_AAM.pdf - Accepted Version Access restricted to UCL open access staff Download (207kB)

Abstract

Active surveillance for low to intermediate risk prostate cancer is a conservative management approach that aims to avoid or delay active treatment until there is evidence of disease progression. In recent years, multiparametric MRI (mpMRI) has been increasingly used in active surveillance, showing great promise in patient selection and monitoring. This has been corroborated by the publication of the Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) recommendations, which define the ideal reporting standards for mpMRI during active surveillance. The PRECISE recommendations include a 1-to-5 scoring system (PRECISE score) for the assessment of radiological change on serial mpMRI scans. A score of 3 indicates radiological stability; a PRECISE score of 1 or 2 indicates radiological regression; and a PRECISE score of 4 or 5 indicates radiological progression. In this article, we discuss the current and future trends of mpMRI during active surveillance and illustrate the natural history of prostate cancer on serial scans according to the PRECISE recommendations. We highlight how the ability to classify radiological change on mpMRI using the PRECISE recommendations helps clinical decision making.

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