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mpMRI Interpretation in Active Surveillance for Prostate Cancer—An overview of the PRECISE score

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Abstract

Active surveillance (AS) is now included in all major guidelines for patients with low-risk PCa and selected patients with intermediate-risk PCa. Several studies have highlighted the potential benefit of multiparametric magnetic resonance imaging (mpMRI) in AS and it has been adopted in some guidelines. However, uncertainty remains about whether serial mpMRI can help to safely reduce the number of required repeat biopsies under AS. In 2017, the European School of Oncology initiated the Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) panel which proposed the PRECISE scoring system to assess the likelihood of radiological tumor progression on serial mpMRI. The PRECISE scoring system remains the only major system evaluated in multiple publications. In this review article, we discuss the current body of literature investigating the application of PRECISE as it is not as yet an established standard in mpMRI reporting. We delineate the strengths of PRECISE and its potential added value. Also, we underline potential weaknesses of the PRECISE scoring system, which might be tackled in future versions to further increase its value in AS.

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Abbreviations

ADC:

Apparent diffusion coefficient

AS:

Active surveillance

DWI:

Diffusion-weighted imaging

mpMRI:

Multiparametric magnetic resonance imaging

NPV:

Negative predictive value

PCa:

Prostate cancer

PI-RADS:

Prostate imaging reporting and data system

PSA:

Prostate-specific antigen

PSA-D:

PSA-density

T2w:

T2-weighted

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Acknowledgements

Received funding from the Deutsche.

Funding

Deutsche Forschungsgemeinschaft, HA 9949/1-1, Felix N. Harder.

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Authors and Affiliations

  1. Institute of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany

    Felix N. Harder

  2. Lunenfeld-Tanenbaum Research Institute, Sinai Health System, 600 University Avenue, Toronto, ON, M5G 1X5, Canada

    Felix N. Harder, Carolina A. M. Heming & Masoom A. Haider

  3. Joint Department of Medical Imaging, University Health Network, Sinai Health System and University of Toronto, Toronto, ON, M5G 1X5, Canada

    Felix N. Harder, Carolina A. M. Heming & Masoom A. Haider

  4. Radiology Department, Instituto Nacional do Cancer (INCa), Rio de Janeiro, Brazil

    Carolina A. M. Heming

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Harder, F.N., Heming, C.A.M. & Haider, M.A. mpMRI Interpretation in Active Surveillance for Prostate Cancer—An overview of the PRECISE score. Abdom Radiol 48, 2449–2455 (2023). https://doi.org/10.1007/s00261-023-03912-2

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