The Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) recommendations standardise the reporting of prostate magnetic resonance imaging (MRI) in patients on active surveillance (AS) for prostate cancer. An international consensus group recently updated these recommendations and identified the areas of uncertainty.
A panel of 38 experts used the formal RAND/UCLA Appropriateness Method consensus methodology. Panellists scored 193 statements using a 1-9 agreement scale, where 9 means full agreement. A summary of agreement, uncertainty, or disagreement (derived from the group median score) and consensus (determined using the Interpercentile Range Adjusted for Symmetry method) was calculated for each statement and presented for discussion before individual rescoring.
Participants agreed that MRI scans must meet a minimum image quality standard (median 9) or be given a score of 'X' for insufficient quality. The current scan should be compared with both baseline and previous scans (median 9), with the PRECISE score being the maximum from any lesion (median 8). PRECISE 3 (stable MRI) was subdivided into 3-V (visible) and 3-NonV (nonvisible) disease (median 9). Prostate Imaging Reporting and Data System/Likert ≥3 lesions should be measured on T2-weighted imaging, using other sequences to aid in the identification (median 8), and whenever possible, reported pictorially (diagrams, screenshots, or contours; median 9). There was no consensus on how to measure tumour size. More research is needed to determine a significant size increase (median 9). PRECISE 5 was clarified as progression to stage ≥T3a (median 9).
The updated PRECISE recommendations reflect expert consensus opinion on minimal standards and reporting criteria for prostate MRI in AS.
The Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) recommendations are used in clinical practice and research to guide the interpretation and reporting of magnetic resonance imaging for patients on active surveillance for prostate cancer. An international panel has updated these recommendations, clarified the areas of uncertainty, and highlighted the areas for further research.
European urology. 2024 Mar 30 [Epub ahead of print]
Cameron Englman, Davide Maffei, Clare Allen, Alex Kirkham, Peter Albertsen, Veeru Kasivisvanathan, Ronaldo Hueb Baroni, Alberto Briganti, Pieter De Visschere, Louise Dickinson, Juan Gómez Rivas, Masoom A Haider, Claudia Kesch, Stacy Loeb, Katarzyna J Macura, Daniel Margolis, Anita M Mitra, Anwar R Padhani, Valeria Panebianco, Peter A Pinto, Guillaume Ploussard, Philippe Puech, Andrei S Purysko, Jan Philipp Radtke, Antti Rannikko, Art Rastinehad, Raphaele Renard-Penna, Francesco Sanguedolce, Lars Schimmöller, Ivo G Schoots, Shahrokh F Shariat, Nicola Schieda, Clare M Tempany, Baris Turkbey, Massimo Valerio, Arnauld Villers, Jochen Walz, Tristan Barrett, Francesco Giganti, Caroline M Moore
Division of Surgery & Interventional Science, University College London, London, UK; Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK., Division of Surgery & Interventional Science, University College London, London, UK; Department of Biomedical Sciences, Humanitas University, Milan, Italy; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK., Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK., Department of Surgery (Urology), UConn Health, Farmington, CT, USA., Division of Surgery & Interventional Science, University College London, London, UK; Department of Urology, University College London Hospital NHS Foundation Trust, London, UK., Department of Radiology, Hospital Israelita Albert Einstein. Sao Paulo, Brazil., Division of Experimental Oncology/Unit of Urology, URI; IRCCS Ospedale San Raffaele, Milan, Italy; University Vita-Salute San Raffaele, Milan, Italy., Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium., Department of Urology, Clinico San Carlos University Hospital, Madrid, Spain., Joint Department of Medical Imaging, Sinai Health System, University of Toronto, Toronto, Canada., Department of Urology, University Hospital Essen, Essen, Germany., Department of Urology and Population Health, New York University Langone Health and Manhattan Veterans Affairs, New York, NY, USA., The Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA., Weill Cornell Medical College, Department of Radiology, New York, NY, USA., Department of Cancer Services, University College London Hospitals NHS Foundation Trust, London, UK., Paul Strickland Scanner Centre, Mount Vernon Hospital, Rickmansworth Road, Middlesex, UK., Department of Radiological Sciences, Oncology and Pathology, Sapienza University of Rome, Rome, Italy., Urologic Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA., Urology Department, La Croix du Sud Hospital, Quint Fonsegrives, France., Department of Radiology, University of Lille, Lille, France., Abdominal Imaging Section, Imaging Institute, Cleveland Clinic, Cleveland, OH, USA., University Dusseldorf, Medical Faculty, Department of Urology, Dusseldorf, Germany., Department of Urology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland., Department of Urology, Lenox Hill Hospital, New York, NY, USA., Department of Radiology, Hôpital Tenon, Assistance Publique-Hôpitaux de Paris, Paris, France., Department of Urology, Autonoma University of Barcelona, Barcelona, Spain; Department of Medicine, Surgery and Pharmacy, Universitá degli studi di Sassari - Italy., Dusseldorf University, Medical Faculty, Department of Diagnostic and Interventional Radiology, Dusseldorf, Germany; Department of Diagnostic, Interventional Radiology and Nuclear Medicine, Marien Hospital Herne, University Hospital of the Ruhr-University Bochum, Herne, Germany., Department of Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands., Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria; Division of Urology, Department of Special Surgery, The University of Jordan, Amman, Jordan., Department of Radiology, University of Ottawa, Ottawa, ON, Canada., Department of Radiology Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA., Molecular Imaging Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA., Department of Urology, Geneva University Hospital, University of Geneva, Geneva, Switzerland., Department of Urology, Hospital Claude Huriez, CHU Lille, Lille, France., Department of Urology, Institut Paoli-Calmettes Cancer Center, Marseille, France., Department of Radiology, University of Cambridge, Addenbrook''s Hospital, Cambridge, UK., Division of Surgery & Interventional Science, University College London, London, UK; Department of Radiology, University College London Hospital NHS Foundation Trust, London, UK. Electronic address: .