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Active Surveillance for Localized Prostate Cancer pp 67–80Cite as

The Role of MRI in Active Surveillance

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Part of the book series: Current Clinical Urology ((CCU))

Abstract

The first use of magnetic resonance imaging in the prostate was an anatomical assessment of newly diagnosed prostate cancer. T1- and T2-weighted sequences were performed to look for local invasion and lymph node involvement. Developments in functional MRI, including the use of gadolinium enhancement, diffusion weighting and spectroscopy, have led to the use of MRI to detect prostate cancer within the gland. MRI can be used to assess the whole gland and preferentially detects prostate cancer of greater Gleason score and volume.

Active surveillance aims to monitor low- or intermediate-risk cancer within the prostate, with the option of radical treatment if more significant disease is detected. Selection for active surveillance is usually done on the basis of PSA, Gleason score and tumour burden on biopsy, along with an assessment of clinical stage. Monitoring whilst on surveillance tends to be done with frequent PSA testing, with the use of digital rectal examination and biopsy at regular intervals. Some have explored the use of repeated MRI scanning in a surveillance programme.

This chapter will explore the rationale behind the use of MRI in the selection and monitoring of men on active surveillance for prostate cancer. The studies of MRI in active surveillance will be reviewed, with an assessment of their merits and limitations. Future studies, which would further assess the use of MRI in this population, will be discussed.

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Author information

Authors and Affiliations

  1. Division of Surgical and Interventional Science, University College London, London, NW1 2PG, UK

    Caroline M. Moore M.D., F.R.C.S. (Urol) & Mark Emberton M.D., F.R.C.S.

  2. Imaging Department, University College London Hospitals Trust, 250 Euston Road, London, NW1 2PG, UK

    Clare Allen F.R.C.R.

  3. Surgery Division, Urology Department, University College London Hospitals Trust, London, UK

    Mark Emberton M.D., F.R.C.S.

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  1. Caroline M. Moore M.D., F.R.C.S. (Urol)
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  2. Clare Allen F.R.C.R.
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  3. Mark Emberton M.D., F.R.C.S.
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Correspondence to Caroline M. Moore M.D., F.R.C.S. (Urol) .

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Editors and Affiliations

  1. University of Toronto, Sunnybrook Health Sciences Centre, Division of Urology, Toronto, M4N 3M5, Ontario, Canada

    Laurence Klotz

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Moore, C.M., Allen, C., Emberton, M. (2012). The Role of MRI in Active Surveillance. In: Klotz, L. (eds) Active Surveillance for Localized Prostate Cancer. Current Clinical Urology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-61779-912-9_6

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  • DOI: https://doi.org/10.1007/978-1-61779-912-9_6

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