BIOMARKERS, PHENOTYPING, GENETICS AND PREDICTIVE MODELS FOR UROLOGIC CARE: Edited by Matthew Cooperberg and Thorsten Schlomm

The role of the multiparametric MRI in the diagnosis of prostate cancer in biopsy-naïve men

Rhudd, Adriana,b; McDonald, Jeanb; Emberton, Markc,d; Kasivisvanathan, Veeruc,d

Author Information

aDepartment of Urology, University of the West Indies, Mona, Jamaica

bDepartment of Urology, North Middlesex University Hospital

cDivision of Surgery and Interventional Sciences, University College London

dDepartment of Urology, University College London Hospital, London, UK

Correspondence to Veeru Kasivisvanathan, Urology Research Group, Room 4.23, 4th Floor, 132 Hampstead Road, London, NW1 2PT, UK. Tel: +44 207 679 9092; fax: +44 207 679 9511; e-mail: [email protected]

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Current Opinion in Urology 27(5):p 488-494, September 2017. | DOI: 10.1097/MOU.0000000000000415

Abstract

Purpose of review 

To review the role of prebiopsy multiparametric MRI in biopsy-naïve men for the detection of clinically significant prostate cancer.

Recent findings 

Recent level 1 evidence shows that multiparametric MRI has high sensitivity and negative predictive value for the detection of clinically significant prostate cancer in biopsy-naïve men. Concurrent developments include important work in the standardization of MRI reporting. The low specificity and positive predictive value of MRI means that biopsy is still necessary following MRI. MRI-targeted prostate biopsy has emerged as an alternative diagnostic test to transrectal ultrasound guided prostate biopsy, though its exact role in biopsy-naïve men and the optimal technique remain to be defined.

Summary 

There is the potential for MRI to be used as a triage test to allow a proportion of men to avoid biopsy and remain on prostate-specific antigen surveillance. MRI-suspicious areas can be sampled more intensively using MRI-targeted biopsy that can be carried out in a variety of ways. Future work should focus on the cost-effectiveness of introducing a prebiopsy MRI pathway in biopsy-naïve men and addressing the training needs for such a change.

https://links.lww.com/COU/A11.

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.

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