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Multiparametric MRI - local staging of prostate cancer and beyond.

Accepted version
Peer-reviewed

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Article

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Authors

Caglic, Iztok 
Kovac, Viljem 

Abstract

Background Accurate local staging is critical for treatment planning and prognosis in patients with prostate cancer (PCa). The primary aim is to differentiate between organ-confined and locally advanced disease with the latter carrying a worse clinical prognosis. Multiparametric MRI (mpMRI) is the imaging modality of choice for the local staging of PCa and has an incremental value in assessing pelvic nodal disease and bone involvement. It has shown superior performance compared to traditional staging based on clinical nomograms, and provides additional information on the site and extent of disease. MRI has a high specificity for diagnosing extracapsular extension (ECE), seminal vesicle invasion (SVI) and lymph node (LN) metastases, however, sensitivity remains poor. As a result, extended pelvic LN dissection remains the gold standard for assessing pelvic nodal involvement, and there has been recent progress in developing advanced imaging techniques for more distal staging. Conclusions T2W-weighted imaging is the cornerstone for local staging of PCa. Imaging at 3T and incorporating both diffusion weighted and dynamic contrast enhanced imaging can further increase accuracy. "Next generation" imaging including whole body MRI and PET-MRI imaging using prostate specific membrane antigen (68Ga-PSMA), has shown promising for assessment of LN and bone involvement as compared to the traditional work-up using bone scintigraphy and body CT.

Description

Keywords

multiparametric MRI, prostate cancer, staging, Aged, Humans, Lymph Nodes, Lymphatic Metastasis, Male, Middle Aged, Multiparametric Magnetic Resonance Imaging, Neoplasm Invasiveness, Neoplasm Staging, Pelvis, Prostatic Neoplasms, Seminal Vesicles

Journal Title

Radiol Oncol

Conference Name

Journal ISSN

1318-2099
1581-3207

Volume Title

53

Publisher

Walter de Gruyter GmbH

Rights

All rights reserved

Version History

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2023-06-02 12:13:29
Published version added
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2019-05-09 14:41:40
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