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Advances in Magnetic Resonance Imaging: How They Are Changing the Management of Prostate Cancer

Sciarra, Alessandro; Barentsz, Jelle; Bjartell, Anders LU ; Eastham, James; Hricak, Hedvig; Panebianco, Valeria and Witjes, J. Alfred (2011) In European Urology 59(6). p.962-977
Abstract
Context: Although magnetic resonance imaging (MRI) is emerging as the most commonly used imaging modality for prostate cancer (PCa) detection, treatment planning, and follow-up, its acceptance has not been uniform. Recently, great interest has been shown in multiparametric MRI, which combines anatomic T2-weighted (T2W) imaging with MR spectroscopic imaging (MRSI), dynamic contrast-enhanced MRI (DCE-MRI), and diffusion-weighted imaging (DWI). Objective: The aim of this article is to review the current roles of these MR techniques in different aspects of PCa management: initial diagnosis, biopsy strategies, planning of radical prostatectomy (RP) and external radiation therapy (RT), and implementation of alternative focal therapies. Evidence... (More)
Context: Although magnetic resonance imaging (MRI) is emerging as the most commonly used imaging modality for prostate cancer (PCa) detection, treatment planning, and follow-up, its acceptance has not been uniform. Recently, great interest has been shown in multiparametric MRI, which combines anatomic T2-weighted (T2W) imaging with MR spectroscopic imaging (MRSI), dynamic contrast-enhanced MRI (DCE-MRI), and diffusion-weighted imaging (DWI). Objective: The aim of this article is to review the current roles of these MR techniques in different aspects of PCa management: initial diagnosis, biopsy strategies, planning of radical prostatectomy (RP) and external radiation therapy (RT), and implementation of alternative focal therapies. Evidence acquisition: The authors searched the Medline and Cochrane Library databases (primary fields: prostatic neoplasm, magnetic resonance). The search was performed without language restriction from January 2008 to November 2010. Evidence synthesis: Initial diagnosis: The data suggest that the combination of T2W MRI and DWI or MRSI with DCE-MRI has the potential to guide biopsy to the most aggressive cancer foci in patients with previously negative biopsies, increasing the accuracy of the procedure. Transrectal MR-guided prostate biopsy can improve PCa detection, but its availability is still limited and the examination time is rather long. Planning of RP: It appears that adding MRSI, DWI, and/or DCE-MRI to T2W MRI can facilitate better preoperative characterization of cancer with regard to location, size, and relationship to prostatic and extraprostatic structures, and it may also facilitate early detection of local recurrence. Thus, use of these MR techniques may improve surgical, oncologic, and functional management. Planning of external RT and focal therapies: MR techniques have similar potential in these areas, but the published data remain very limited. Conclusions: MRI technology is continuously evolving, and more extensive use of MRI technology in clinical trials and practice will help to improve PCa diagnosis and treatment planning. (C) 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Prostate neoplasm, Imaging, Magnetic resonance
in
European Urology
volume
59
issue
6
pages
962 - 977
publisher
Elsevier
external identifiers
  • wos:000290015300020
  • scopus:79955606529
ISSN
1873-7560
DOI
10.1016/j.eururo.2011.02.034
language
English
LU publication?
yes
id
c884e438-f831-4d19-9002-63d8d93f0519 (old id 1987850)
date added to LUP
2011-07-01 09:29:00
date last changed
2017-10-22 04:13:41
@article{c884e438-f831-4d19-9002-63d8d93f0519,
  abstract     = {Context: Although magnetic resonance imaging (MRI) is emerging as the most commonly used imaging modality for prostate cancer (PCa) detection, treatment planning, and follow-up, its acceptance has not been uniform. Recently, great interest has been shown in multiparametric MRI, which combines anatomic T2-weighted (T2W) imaging with MR spectroscopic imaging (MRSI), dynamic contrast-enhanced MRI (DCE-MRI), and diffusion-weighted imaging (DWI). Objective: The aim of this article is to review the current roles of these MR techniques in different aspects of PCa management: initial diagnosis, biopsy strategies, planning of radical prostatectomy (RP) and external radiation therapy (RT), and implementation of alternative focal therapies. Evidence acquisition: The authors searched the Medline and Cochrane Library databases (primary fields: prostatic neoplasm, magnetic resonance). The search was performed without language restriction from January 2008 to November 2010. Evidence synthesis: Initial diagnosis: The data suggest that the combination of T2W MRI and DWI or MRSI with DCE-MRI has the potential to guide biopsy to the most aggressive cancer foci in patients with previously negative biopsies, increasing the accuracy of the procedure. Transrectal MR-guided prostate biopsy can improve PCa detection, but its availability is still limited and the examination time is rather long. Planning of RP: It appears that adding MRSI, DWI, and/or DCE-MRI to T2W MRI can facilitate better preoperative characterization of cancer with regard to location, size, and relationship to prostatic and extraprostatic structures, and it may also facilitate early detection of local recurrence. Thus, use of these MR techniques may improve surgical, oncologic, and functional management. Planning of external RT and focal therapies: MR techniques have similar potential in these areas, but the published data remain very limited. Conclusions: MRI technology is continuously evolving, and more extensive use of MRI technology in clinical trials and practice will help to improve PCa diagnosis and treatment planning. (C) 2011 European Association of Urology. Published by Elsevier B.V. All rights reserved.},
  author       = {Sciarra, Alessandro and Barentsz, Jelle and Bjartell, Anders and Eastham, James and Hricak, Hedvig and Panebianco, Valeria and Witjes, J. Alfred},
  issn         = {1873-7560},
  keyword      = {Prostate neoplasm,Imaging,Magnetic resonance},
  language     = {eng},
  number       = {6},
  pages        = {962--977},
  publisher    = {Elsevier},
  series       = {European Urology},
  title        = {Advances in Magnetic Resonance Imaging: How They Are Changing the Management of Prostate Cancer},
  url          = {http://dx.doi.org/10.1016/j.eururo.2011.02.034},
  volume       = {59},
  year         = {2011},
}