Dramatic increase in the utilization of multiparametric magnetic resonance imaging for detection and management of prostate cancer
- 537 Downloads
Multiparametric MRI (mpMRI) of the prostate is an evolving technology that provides functional information of the prostate that helps distinguish benign from malignant lesions. We hypothesized that mpMRI is rapidly adopted in the US to fill the unmet need for a non-invasive, accurate screening tool. The aim of this study is to assess the increasing utilization of mpMRI for the diagnosis and management of prostate cancer.
We conducted a retrospective review of an institutional clinical data repository of four million patients. Clinical information from all men undergoing mpMRI from October 2013 to December 2015 was collected in a prospectively designed database. Individual chart reviews were performed for each patient.
1521 mpMRI of the prostate were performed with an increase in the use of 486% over 26 months. The most common indication for mpMRI was abnormal screening (64%) and 47% of these men went on to prostate biopsy, either by cognitive mapping (65%) or MRI–US fusion targeting (35%). 261 men elected to defer prostate needle biopsy after informative decision-making with their urologist. 12.7% of mpMRI were performed for active surveillance, 7.5% for clinical staging, and 3.2% by radiation oncologists planning radiotherapy. 7% of mpMRI were performed to evaluate the pelvis for biochemical recurrence, a third of which identified a region of suspicion for targeted.
Prostate mpMRI is increasingly performed for both the diagnosis and management of prostate cancer. As clinical utilization increases along with the diffusion of technology and radiologic expertise, MpMRI has the potential to influence clinical decision-making and fulfill the need for a non-invasive, accurate tool for the diagnosis and management of prostate cancer.
KeywordsMutliparametric magnetic resonance Imaging Prostate cancer Practice patterns Prostate biopsy Active surveillance
Compliance with ethical standards
No funding was received for this study.
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.
Statement of informed consent was not applicable since the manuscript does not contain any patient data.
- 3.Pinker K, Baltzer P, Bogner W, et al. (2015) Multiparametric MR imaging with high-resolution dynamic contrast-enhanced and diffusion-weighted imaging at 7 T improves the assessment of breast tumors: a feasibility study. Radiology 276(2):360–370. doi: 10.1148/radiol.15141905 CrossRefPubMedGoogle Scholar
- 6.Wysock JS, Rosenkrantz AB, Huang WC, et al. (2014) A prospective, blinded comparison of magnetic resonance (MR) imaging-ultrasound fusion and visual estimation in the performance of MR-targeted prostate biopsy: the PROFUS trial. Eur Urol 66(2):343–351. doi: 10.1016/j.eururo.2013.10.048 CrossRefPubMedGoogle Scholar
- 11.Alberts AR, Schoots IG, Bokhorst LP, et al. (2015) Risk-based patient selection for magnetic resonance imaging-targeted prostate biopsy after negative transrectal ultrasound-guided random biopsy avoids unnecessary magnetic resonance imaging scans. Eur Urol. doi: 10.1016/j.eururo.2015.11.018 Google Scholar