Objective: To comprehensively review the literature on the integration of MRI as a diagnostic tool in prostate cancer screening and offer practical recommendations for optimizing its use.
Methods: Existing research studies, clinical guidelines, and expert opinions were reviewed to support the optimization standards for MRI use in screening. Consolidated screening principles were used to make appropriate recommendations regarding the integration of MRI into the diagnostic pathway.
Results: To strike a balance between the potential benefits of early detection on mortality and minimizing the harm of over-diagnosing indolent cancers, it is necessary to have a clear understanding of the context of MRI use. The key to optimization is patient selections and MRI-targeted biopsies. For men at higher than average risk, it is essential to use screening-specific MRI protocols and establish accuracy levels and interpretation criteria. Optimization of readings by the automation of data acquisition, image quality monitoring, post-processing, radiologist certification, and deep-learning computer-aided software is needed. The optimal utilization of MRI involves its integration into a multistep diagnostic pathway, supported by a quality-assured and cost-effective infrastructure that ensures community-wide access to imaging.
Conclusion: MRI in the prostate cancer screening pathway can bring substantial diagnostic benefits. By carefully considering its advantages, limitations, and safety concerns and integrating it into a multistep diagnostic pathway, clinicians can improve outcomes while minimizing harm to screening participants.
For more information see:
Padhani AR, Schoots IG. Prostate cancer screening-stepping forward with MRI. Eur Radiol. 2023 Oct;33(10):6670-6676. doi: 10.1007/s00330-023-09673-2. Epub 2023 May 8. PMID: 37154952.
21 сен 2023
