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The role of MRI in prostate cancer: current and future directions

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Abstract

There has been an increasing role of magnetic resonance imaging (MRI) in the management of prostate cancer. MRI already plays an essential role in the detection and staging, with the introduction of functional MRI sequences. Recent advancements in radiomics and artificial intelligence are being tested to potentially improve detection, assessment of aggressiveness, and provide usefulness as a prognostic marker. MRI can improve pretreatment risk stratification and therefore selection of and follow-up of patients for active surveillance. MRI can also assist in guiding targeted biopsy, treatment planning and follow-up after treatment to assess local recurrence. MRI has gained importance in the evaluation of metastatic disease with emerging technology including whole-body MRI and integrated positron emission tomography/MRI, allowing for not only better detection but also quantification. The main goal of this article is to review the most recent advances on MRI in prostate cancer and provide insights into its potential clinical roles from the radiologist’s perspective. In each of the sections, specific roles of MRI tailored to each clinical setting are discussed along with its strengths and weakness including already established material related to MRI and the introduction of recent advancements on MRI.

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Abbreviations

ADC:

Apparent diffusion coefficient

ADT:

Androgren-deprivation therapy

AUC:

Area under the receiver operating characteristic curve

BCR:

Biochemical recurrence

BS:

Bone scintigraphy

CADx:

Computed-aided diagnosis

csPCa:

Clinically significant prostate cancer

CT:

Computed tomography

DCE:

Dynamic contrast-enhanced

DL:

Deep learning

DRE:

Digital rectal exam

DWI:

Diffusion-weighted imaging

EPE:

Extraprostatic extension

GS:

Gleason score

MET-RADS-P:

METastasis reporting and data system for prostate cancer

mpMRI:

Multiparametric magnetic resonance imaging

MRI:

Magnetic resonance imaging

MRI-Tb:

Magnetic resonance imaging-targeted biopsy

MRS:

Magnetic resonance spectroscopy

NCCN:

National comprehensive cancer network

NVB:

Neurovascular bundle

PET:

Positron emission tomography

PI-RADS:

Prostate imaging reporting and data system

PI-RR:

Prostate imaging for recurrence reporting

PSA:

Prostate-specific antigen

PSMA:

Prostate-specific membrane antigen

PRECISE:

Prostate cancer radiological estimation of change in sequential evaluation

SVI:

Seminal vesicle invasion

T1WI:

T1-weighted image

T2WI:

T2-weighted image

US:

Ultrasound

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Funding

This study was funded in part through the NIH/NCI Cancer Center Support Grant P30 CA008748.

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  1. Maria Clara Fernandes and Onur Yildirim contributed equally.

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  1. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA

    Maria Clara Fernandes, Onur Yildirim, Sungmin Woo, Hebert Alberto Vargas & Hedvig Hricak

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  1. Maria Clara Fernandes
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  2. Onur Yildirim
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Correspondence to Sungmin Woo.

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Since May 2017, Dr. Hricak has served on the Board of Directors of Ion Beam Applications (IBA), a publicly traded company, and she receives annual compensation for her service. Furthermore, Dr. Hricak is a member of the External Advisory Board of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins (SKCCC), the International Advisory Board of the University of Vienna, Austria, the Scientific Committee of the DKFZ (German Cancer Research Center), Germany, the Board of Trustees the DKFZ (German Cancer Research Center), Germany and a member of the Scientific Advisory Board (SAB) of Euro-BioImaging ERIC; she does not receive financial compensation for any of these roles. The other authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

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Fernandes, M.C., Yildirim, O., Woo, S. et al. The role of MRI in prostate cancer: current and future directions. Magn Reson Mater Phy 35, 503–521 (2022). https://doi.org/10.1007/s10334-022-01006-6

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