The current diagnostic pathway for prostate cancer has resulted in overdiagnosis and consequent overtreatment as well as underdiagnosis and missed diagnoses in many men. Multiparametric MRI (mpMRI) of the prostate has been identified as a test that could mitigate these diagnostic errors. The performance of mpMRI can vary depending on the population being studied, the execution of the MRI itself, the experience of the radiologist, whether additional biomarkers are considered and whether mpMRI-targeted biopsy is carried out alone or in addition to systematic biopsy. A number of challenges to implementation remain, such as ensuring high-quality execution and reporting of mpMRI and ensuring that this diagnostic pathway is cost-effective. Nevertheless, emerging clinical trial data support the adoption of this technology as part of the standard of care for the diagnosis of prostate cancer.
Nature reviews. Urology. 2019 Jul 17 [Epub ahead of print]
Armando Stabile, Francesco Giganti, Andrew B Rosenkrantz, Samir S Taneja, Geert Villeirs, Inderbir S Gill, Clare Allen, Mark Emberton, Caroline M Moore, Veeru Kasivisvanathan
Division of Surgery and Interventional Science, University College London, London, UK. ., Division of Surgery and Interventional Science, University College London, London, UK., Department of Radiology, NYU Langone Health, New York, NY, USA., Department of Radiology, Ghent University Hospital, Ghent, Belgium., USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA., Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK.