Peter L. CHOYKE, Julie Y. AN, Abhinav SİDANA, Bradford J. WOOD, Peter A. PİNTO, İsmail Barış TÜRKBEY

Multiparametric Magnetic Resonance Imaging for Active Surveillance of Prostate Cancer

Active surveillance has gained popularity as anacceptable management option for men with low-riskprostate cancer. Successful utilization of this strategycan delay or prevent unnecessary interventions - therebyreducing morbidity associated with overtreatment. Theusefulness of active surveillance primarily depends oncorrect identification of patients with low-risk disease.However, current population-wide algorithms and toolsdo not adequately exclude high-risk disease, therebylimiting the confidence of clinicians and patients togo on active surveillance. Novel imaging tools suchas mpMRI provide information about the size andlocation of potential cancers enabling more informedtreatment decisions. The term "multiparametric" inprostate mpMRI refers to the summation of severalMRI series into one examination whose initial goalis to identify potential clinically-significant lesionssuitable for targeted biopsy. The main advantages ofMRI are its superior anatomic resolution and the lackof ionizing radiation. Recently, the Prostate ImagingReportingand Data System has been instituted as aninternational standard for unifying mpMRI results.The imaging sequences in mpMRI defined by ProstateImaging Reporting and Data System version 2 includes:T2-weighted MRI, diffusion-weighted MRI, derivedapparent-diffusion coefficient from diffusion-weightedMRI, and dynamic contrast-enhanced MRI. The useof mpMRI prior to starting active surveillance couldprevent those with missed, high-grade lesions fromgoing on active surveillance, and reassure those withminimal disease who may be hesitant to take part inactive surveillance. Although larger validation studiesare still necessary, preliminary results suggest mpMRIhas a role in selecting patients for active surveillance.Less certain is the role of mpMRI in monitoring patientson active surveillance, as data on this will take a longtime to mature. The biggest obstacles to routine use ofprostate MRI are quality control, cost, reproducibility,and access. Nevertheless, there is great a potential formpMRI to improve outcomes and quality of treatment.The major roles of MRI will continue to expand and itsemerging use in standard of care approaches becomesmore clearly defined and supported by increasing levelsof data.

PDF

___

1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2016. CA Cancer J Clin 2016;66:7-30.
2. Potosky AL, Miller BA, Albertsen PC, Kramer BS. The role of increasing detection in the rising incidence of prostate cancer. JAMA 1995;273:548- 52.
3. Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin 2013;63:11-30.
4. Andriole GL, Crawford ED, Grubb RL 3rd, Buys SS, Chia D, Church TR, et al. Mortality results from a randomized prostate-cancer screening trial. N Engl J Med 2009;360:1310-9.
5. Schröder FH, Hugosson J, Roobol MJ, Tammela TL, Ciatto S, Nelen V, et al. Screening and prostate-cancer mortality in a randomized European study. N Engl J Med 2009;360:1320-8.
6. Hugosson J, Carlsson S, Aus G, Bergdahl S, Khatami A, Lodding P, et al. Mortality results from the Göteborg randomised population-based prostatecancer screening trial. Lancet Oncol 2010;11:725-32.
7. Jemal A, Fedewa SA, Ma J, Siegel R, Lin CC, Brawley O, et al. Prostate Cancer Incidence and PSA Testing Patterns in Relation to USPSTF Screening Recommendations. JAMA 2015;314:2054-61.
8. Shoag JE, Mittal S, Hu JC. Reevaluating PSA Testing Rates in the PLCO Trial. N Engl J Med 2016;374:1795-6.
9. Chou R, Croswell JM, Dana T, Bougatsos C, Blazina I, Fu R, et al. Screening for prostate cancer: a review of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med 2011;155:762-71.
10. Klotz L, Vesprini D, Sethukavalan P, Jethava V, Zhang L, Jain S, et al. Long-term follow-up of a large active surveillance cohort of patients with prostate cancer. J Clin Oncol 2015;33:272-7.
11. Cooperberg MR, Broering JM, Kantoff PW, Carroll PR. Contemporary trends in low risk prostate cancer: risk assessment and treatment. J Urol 2007;178:S14-9.
12. Womble PR, Montie JE, Ye Z, Linsell SM, Lane BR, Miller DC. Contemporary use of initial active surveillance among men in Michigan with low-risk prostate cancer. Eur Urol 2015;67:44-50.
13. Cooperberg MR, Carroll PR. Trends in Management for Patients With Localized Prostate Cancer, 1990-2013. Jama 2015;314:80-2.
14. Ingimarsson JP, Celaya MO, Laviolette M, Rees JR, Hyams ES. Trends in initial management of prostate cancer in New Hampshire. Cancer causes & control: CCC 2015;26:923-9.
15. Tosoian JJ, Mamawala M, Epstein JI, Landis P, Wolf S, Trock BJ, et al. Intermediate and Longer-Term Outcomes From a Prospective ActiveSurveillance Program for Favorable-Risk Prostate Cancer. J Clin Oncol 2015;33:3379-85.
16. Louis AS, Kalnin R, Maganti M, Pintilie M, Matthew AG, Finelli A, et al. Oncologic outcomes following radical prostatectomy in the active surveillance era. Can Urol Assoc J 2013;7:E475-80.
17. Weerakoon M, Papa N, Lawrentschuk N, Evans S, Millar J, Frydenberg M, et al. The current use of active surveillance in an Australian cohort of men: a pattern of care analysis from the Victorian Prostate Cancer Registry. BJU Int 2015;115:50-6.
18. Loeb S, Folkvaljon Y, Curnyn C, Robinson D, Bratt O, Stattin P. Uptake of Active Surveillance for Very-Low-Risk Prostate Cancer in Sweden. JAMA Oncol 2016.
19. Turkbey B, Brown AM, Sankineni S, Wood BJ, Pinto PA, Choyke PL. Multiparametric prostate magnetic resonance imaging in the evaluation of prostate cancer. CA Cancer J Clin 2016;66:326-36.
20. Weinreb JC, Barentsz JO, Choyke PL, Cornud F, Haider MA, Macura KJ, et al. PI-RADS Prostate Imaging - Reporting and Data System: 2015, Version 2. Eur Urol 2016;69:16-40.
21. Pinto PA, Chung PH, Rastinehad AR, Baccala AA Jr, Kruecker J, Benjamin CJ, et al. Magnetic resonance imaging/ultrasound fusion guided prostate biopsy improves cancer detection following transrectal ultrasound biopsy and correlates with multiparametric magnetic resonance imaging. J Urol 2011;186:1281-5.
22. Haider MA, van der Kwast TH, Tanguay J, Evans AJ, Hashmi AT, Lockwood G, et al. Combined T2-weighted and diffusion-weighted MRI for localization of prostate cancer. AJR Am J Roentgenol 2007;189:323- 8.
23. Kim CK, Park BK, Kim B. Diffusion-weighted MRI at 3 T for the evaluation of prostate cancer. AJR Am J Roentgenol 2010;194:1461-9.
24. Sato C, Naganawa S, Nakamura T, Kumada H, Miura S, Takizawa O, et al. Differentiation of noncancerous tissue and cancer lesions by apparent diffusion coefficient values in transition and peripheral zones of the prostate. J Magn Reson Imaging 2005;21:258-62.
25. Hosseinzadeh K, Schwarz SD. Endorectal diffusion-weighted imaging in prostate cancer to differentiate malignant and benign peripheral zone tissue. J Magn Reson Imaging 2004;20:654-61.
26. Sahibzada I, Batura D, Hellawell G. Validating multiparametric MRI for diagnosis and monitoring of prostate cancer in patients for active surveillance. Int Urol Nephrol 2016;48:529-33.
27. Zhao C, Gao G, Fang D, Li F, Yang X, Wang H, et al. The efficiency of multiparametric magnetic resonance imaging (mpMRI) using PI-RADS Version 2 in the diagnosis of clinically significant prostate cancer. Clinical imaging 2016;40:885-8.
28. Niu XK, Li J, Das SK, Xiong Y, Yang CB, Peng T. Developing a nomogram based on multiparametric magnetic resonance imaging for forecasting high-grade prostate cancer to reduce unnecessary biopsies within the prostate-specific antigen gray zone. BMC Med Imaging 2017;17:11.
29. Jain S, Loblaw A, Vesprini D, Zhang L, Kattan MW, Mamedov A, et al. Gleason Upgrading with Time in a Large Prostate Cancer Active Surveillance Cohort. J Urol 2015;194:79-84.
30. Bott SR, Young MP, Kellett MJ, Parkinson MC. Anterior prostate cancer: is it more difficult to diagnose? BJU Int 2002;89:886-9.
31. Thompson I, Thrasher JB,Aus G, BurnettAL, Canby-Hagino ED, Cookson MS, et al. Guideline for the management of clinically localized prostate cancer: 2007 update. J Urol 2007;177:2106-31.
32. Mottet N, Bellmunt J, Bolla M, Briers E, Cumberbatch MG, De Santis M, et al. EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent. Eur Urol 2017;71:618-29.
33. Schroder F, Kattan MW. The comparability of models for predicting the risk of a positive prostate biopsy with prostate-specific antigen alone: a systematic review. Eur Urol 2008;54:274-90.
34. Pepe P, Pennisi M, Fraggetta F. Anterior prostate biopsy at initial and repeat evaluation: is it useful to detect significant prostate cancer? Int Braz J Urol 2015;41:844-8.
35. Mullins JK, Bonekamp D, Landis P, Begum H, Partin AW, Epstein JI, et al. Multiparametric magnetic resonance imaging findings in men with low-risk prostate cancer followed using active surveillance. BJU Int 2013;111:1037-45.
36. Vargas HA, Akin O, Afaq A, Goldman D, Zheng J, Moskowitz CS, et al. Magnetic resonance imaging for predicting prostate biopsy findings in patients considered for active surveillance of clinically low risk prostate cancer. J Urol 2012;188:1732-8.
37. Muthigi A, George AK, Sidana A, Kongnyuy M, Simon R, Moreno V, et al. Missing the Mark: Prostate Cancer Upgrading by Systematic Biopsy over Magnetic Resonance Imaging/Transrectal Ultrasound Fusion Biopsy. J Urol 2017;197:327-34.
38. Siddiqui MM, George AK, Rubin R, Rais-Bahrami S, Parnes HL, Merino MJ, et al. Efficiency of Prostate Cancer Diagnosis by MR/Ultrasound Fusion-Guided Biopsy vs Standard Extended-Sextant Biopsy for MRVisible Lesions. J Natl Cancer Inst 2016;108.
39. Alam R, Carter HB, Landis P, Epstein JI, Mamawala M. Conditional probability of reclassification in an active surveillance program for prostate cancer. J Urol 2015;193:1950-5.
40. Siddiqui MM, Rais-Bahrami S, Truong H, Stamatakis L, Vourganti S, Nix J, et al. Magnetic resonance imaging/ultrasound-fusion biopsy significantly upgrades prostate cancer versus systematic 12-core transrectal ultrasound biopsy. Eur Urol 2013;64:713-9.
41. Turkbey B, Mani H, Shah V, Rastinehad AR, Bernardo M, Pohida T, et al. Multiparametric 3T prostate magnetic resonance imaging to detect cancer: histopathological correlation using prostatectomy specimens processed in customized magnetic resonance imaging based molds. J Urol 2011;186:1818-24.
42. Schouten MG, Hoeks CM, Bomers JG, Hulsbergen-van de Kaa CA, Witjes JA, Thompson LC, et al. Location of Prostate Cancers Determined by Multiparametric and MRI-Guided Biopsy in Patients With Elevated Prostate-Specific Antigen Level and at Least One Negative Transrectal Ultrasound-Guided Biopsy. AJR Am J Roentgenol 2015;205:57-63.
43. Shinmoto H, Tamura C, Soga S, Okamura T, Horiguchi A, Asano T, et al. Anterior Prostate Cancer: Diagnostic Performance of T2-Weighted MRI and an Apparent Diffusion Coefficient Map. AJR Am J Roentgenol 2015;205:W185-92.
44. Rothwax JT, George AK, Wood BJ, Pinto PA. Multiparametric MRI in biopsy guidance for prostate cancer: fusion-guided. Biomed Res Int 2014;2014:439171.
45. Streeter EH, Brewster SF. NICE guidelines on Prostate Cancer Active Surveillance: is UK practice leading the world? BJU Int 2015;115:12- 3.
46. Miller DC, Gruber SB, Hollenbeck BK, Montie JE, Wei JT. Incidence of initial local therapy among men with lower-risk prostate cancer in the United States. J Natl Cancer Inst 2006;98:1134-41.
47. Kelly SP, Van Den Eeden SK, Hoffman RM, Aaronson DS, Lobo T, Luta G, et al. Sociodemographic and Clinical Predictors of Switching to Active Treatment among a Large, Ethnically Diverse Cohort of Men with Low Risk Prostate Cancer on Observational Management. J Urol 196:734-40.
48. Felker ER, Wu J, Natarajan S, Margolis DJ, Raman SS, Huang J, et al. Serial Magnetic Resonance Imaging in Active Surveillance of Prostate Cancer: Incremental Value. J Urol 2016;195:1421-7.
49. Habibian DJ, Liu CC, Dao A, Kosinski KE, Katz AE. Imaging Characteristics of Prostate Cancer Patients Who Discontinued Active Surveillance on 3-T Multiparametric Prostate MRI. AJR Am J Roentgenol 2017;208:564-9.
50. Mohler JL, Armstrong AJ, Bahnson RR, D'Amico AV, Davis BJ, Eastham JA, et al. Prostate Cancer, Version 1.2016. Journal of the National Comprehensive Cancer Network: JNCCN 2016;14:19-30.
51. Lee EK, Baack J, Penn H, Bromfield CT, Duchene DA, Thrasher JB, et al. Active surveillance for prostate cancer in a veteran population. Can J Urol 2010;17:5429-35.
52. Rais-Bahrami S, Türkbey B, Rastinehad AR, Walton-Diaz A, Hoang AN, Siddiqui MM, et al. Natural history of small index lesions suspicious for prostate cancer on multiparametric MRI: recommendations for interval imaging follow-up. Diagn Interv Radiol 2014;20:293-8.
53. Moore CM, Petrides N, Emberton M. Can MRI replace serial biopsies in men on active surveillance for prostate cancer? Curr Opin Urol 2014;24:280-7.
54. Mulcahy N. USPSTF Re-evaluates PSA Testing; Here's Their Plan. Medscape Medical News: Oncology 2016; http://www.medscape.com/ viewarticle/862845. Accessed March 5, 2017.
55. RE: USPSTF Draft Research Plan for Prostate Cancer: Screening [press release]. Linthicum, MD: American Urological Association, November 24, 2015.