The Role of MRI in Active Surveillance for Prostate Cancer
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Approximately one in seven American men will be diagnosed with prostate cancer during his lifetime, and at least 50 % of newly diagnosed patients will present with low-risk disease. In the last decade, the decision-making paradigm for management has shifted due to high rates of disease detection and overtreatment, attributed to prostate-specific antigen screening, with more men deferring definitive treatment for active surveillance. The advent of multiparametric magnetic resonance imaging (MP-MRI) and MRI/ transrectal ultrasound-guided fusion-guided prostate biopsy has refined the process of diagnosis, identifying patients with clinically-significant cancer and larger disease burden who would most likely benefit from intervention. In parallel, the utilization of MP-MRI in the surveillance of low-grade, low-volume disease is on the rise, reflecting support in a growing body of literature. The aim of this review is to appraise and summarize the data evaluating the role of magnetic resonance imaging in active surveillance for prostate cancer.
KeywordsActive surveillance Prostate cancer Multiparametric MRI Outcomes Cancer detection
The National Institutes of Health (NIH) Medical Research Scholars Program is a public-private partnernship supported jointly by the NIH and generous contributions to the Foundation for the NIH from Pfizer Inc., The Doris Duke Charitable Foundation, The Newport Foundation, The American Association for Dental Research, The Howard Hughes Medical Institute, and the Colgate-Palmolive Company, as well as other private donors.
Compliance with Ethics Guidelines
Conflict of Interest
Peter A. Pinto reports a patent US 8447384B2 issued.
Michele Fascelli, Arvin K. George, Thomas Frye, Baris Turkbey, and Peter L. Choyke each declare no potential conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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