Schoots, IG;
Moore, CM;
Rouvière, O;
(2017)
Role of MRI in low-risk prostate cancer: finding the wolf in sheep's clothing or the sheep in wolf's clothing?
Current Opinion in Urology
, 27
(3)
pp. 238-245.
10.1097/MOU.0000000000000397.
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Abstract
PURPOSE OF REVIEW: In men on active surveillance for localized prostate cancer, MRI and MRI-targeted biopsies can be used prior to confirmatory or surveillance biopsy, to detect individuals with high-grade cancer (the wolf in sheep's clothing). However, some men will have low-risk disease despite adverse MRI findings (the sheep in wolf's clothing). We review the value addition of MRI-targeted biopsies in comparison to systematic transrectal ultrasound-guided biopsies, using pathological reclassification as an end-point. RECENT FINDINGS: At confirmatory and surveillance biopsies, both the MRI-targeted and repeat standard biopsies have shown value in identifying histologically adverse findings in men with low-risk prostate cancer. For maximal detection of clinically significant cancer, a prebiopsy MRI should be performed together with both MRI-targeted and systematic transrectal ultrasound-guided biopsies. Stable disease on MRI may reduce the need for serial biopsies in some men on active surveillance. SUMMARY: Prostate MRI and subsequent MRI-targeted biopsies are worthwhile to the current management of men with low-risk prostate cancer on active surveillance. Prostate MRI, in combination with a multivariable risk-prediction model may help in identifying both the wolf in sheep's clothing and the sheep in wolf's clothing, and in potentially reducing the need for serial biopsies.
| Type: | Article |
|---|---|
| Title: | Role of MRI in low-risk prostate cancer: finding the wolf in sheep's clothing or the sheep in wolf's clothing? |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1097/MOU.0000000000000397 |
| Publisher version: | http://doi.org/10.1097/MOU.0000000000000397 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | active surveillance, biopsies, monitoring, MRI, prostate cancer, risk prediction, systematic review |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention |
| URI: | https://discovery.ucl.ac.uk/id/eprint/1549698 |
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