We update the prior AUA SOP for MRI of the prostate and summarize the available data about the technique and clinical use of MRI in the diagnosis and management of prostate cancer. This updated SOP provides practical recommendations for MRI use in the screening, diagnosis, staging, treatment, and surveillance of prostate cancer.
A panel of clinicians from the AUA and SAR with expertise in the diagnosis and management of prostate cancer evaluated the current published literature on the use and technique MRI for this disease. When adequate studies were available for analysis, recommendations were made on the basis of data and when adequate studies were not available, recommendations were made on the basis of expert consensus.
Prostate MRI should be performed according to technical specifications, technique standards, and interpreted according to standard reporting. Data support the use of MRI in men with a previous negative biopsy and ongoing concerns about increased risk of prostate cancer. Sufficient data now also exist to support the recommendation of MRI prior to biopsy for all men, without previous history of biopsy, under consideration for prostate biopsy. There is currently insufficient evidence to recommend MRI for screening, staging or surveillance of prostate cancer.
Utility of prostate MRI in the risk stratification, diagnosis, and treatment pathway of men with prostate cancer is expanding. When a quality prostate MRI is obtained, current evidence now supports its use in men at risk of harboring prostate cancer prior to their first biopsy, as well as in men with a rising PSA following an initial negative standard prostate biopsy procedure.
The Journal of urology. 2019 Oct 23 [Epub ahead of print]
Marc A Bjurlin, Peter R Carroll, Scott Eggener, Pat F Fulgham, Daniel J Margolis, Peter A Pinto, Andrew B Rosenkrantz, Jonathan N Rubenstein, Daniel B Rukstalis, Samir S Taneja, Baris Turkbey
University of North Carolina, Chapel Hill, North Carolina., University of California San Francisco, San Francisco, California., The University of Chicago Medical Center, Chicago, Illinois., Texas Health Presbyterian Hospital of Dallas, Dallas, Texas., Weill Cornell Medical College, New York, New York., National Cancer Institute, National Institutes of Health, Bethesda, Maryland., NYU Langone Medical Center, New York, New York., Chesapeake Urology Associates, Baltimore, Maryland., Wake Forest Baptist Medical Center, Winston-Salem, North Carolina.