Skip to main content
SpringerLink
Log in

Impact of multiparametric MRI and MRI-targeted biopsy on pre-therapeutic risk assessment in prostate cancer patients candidate for radical prostatectomy

  • Topic Paper
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Purpose

To assess the current status and future potential of multiparametric MRI (mpMRI) and MRI-targeted biopsy (MRI-TBx) on the pretherapeutic risk assessment in prostate cancer patients’ candidates for radical prostatectomy.

Methods

A literature search of the MEDLINE/PubMed and Scopus database was performed. English-language original and review articles were analyzed and summarized after an interactive peer-review process of the panel.

Results

Pretherapeutic risk assessment tools should be based on target plus systematic biopsies, where the addition of systematic biopsy (TRUS-Bx) to the mpMRI-target cores is associated with a lower rate of upgrading at final pathology. The combination of mpMRI findings with clinical parameters outperforms models based on clinical parameters alone in the prediction of adverse pathological outcomes and oncological results. This is particularly true when a specialized radiologist is present.

Conclusion

The combination of mpMRI findings and clinical parameters should be considered to improve patient stratification in the pretherapeutic risk assessment. There is an urgent need to develop or include MRI data and MRI-TBx findings in available preoperative risk tools. This will allow improving the pretherapeutic risk assessment, providing important additional information for patient-tailored treatment planning and optimizing outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Guidelines on prostate cancer (2018) European Association of Urology. http://uroweb.org/guideline/prostate-cancer/. Accessed Mar 2018

  2. National Comprehensive Cancer Network (2017) Clinical practice guidelines in oncology (NCCN Guidelines®). Prostate cancer. https://www.nccn.org/professionals/physician_gls/default.aspx. Accessed Mar 2018

  3. Gontero P, Kirby RS (2005) Nerve-sparing radical retropubic prostatectomy: techniques and clinical considerations. Prostate Cancer Prostatic Dis 8:133–139

    Article  CAS  Google Scholar 

  4. Sokoloff MH, Brendler CB (2001) Indications and contraindications for nerve-sparing radical prostatectomy. Urol Clin North Am 28:535–543

    Article  CAS  Google Scholar 

  5. Suardi N, Larcher A, Haese A et al (2014) Indication for and extension of pelvic lymph node dissection during robot-assisted radical prostatectomy: an analysis of five European institutions. Eur Urol 66:635–643

    Article  Google Scholar 

  6. de Rooij M, Hamoen EH, Witjes JA, Barentsz JO, Rovers MM (2016) Accuracy of magnetic resonance imaging for local staging of prostate cancer: a diagnostic Meta-analysis. Eur Urol 70:233–245

    Article  Google Scholar 

  7. Hovels AM, Heesakkers RA, Adang EM et al (2008) The diagnostic accuracy of CT and MRI in the staging of pelvic lymph nodes in patients with prostate cancer: a meta-analysis. Clin Radiol 63:387–395

    Article  CAS  Google Scholar 

  8. Steuber T, Graefen M, Haese A et al (2006) Validation of a nomogram for prediction of side specific extracapsular extension at radical prostatectomy. J Urol 175:939–944 [discussion 44]

    Article  Google Scholar 

  9. Eifler JB, Feng Z, Lin BM et al (2013) An updated prostate cancer staging nomogram (Partin tables) based on cases from 2006 to 2011. BJU Int 111:22–29

    Article  Google Scholar 

  10. Memorial sloan kettering cancer center. Prostate cancer nomograms pre-radical prostatectomy. http://www.mskcc.org/nomograms/prostate/pre_op. Accessed Feb 2018

  11. Briganti A, Larcher A, Abdollah F et al (2012) Updated nomogram predicting lymph node invasion in patients with prostate cancer undergoing extended pelvic lymph node dissection: the essential importance of percentage of positive cores. Eur Urol 61:480–487

    Article  Google Scholar 

  12. Futterer JJ, Briganti A, De Visschere P et al (2015) Can clinically significant prostate cancer be detected with multiparametric magnetic resonance imaging? A systematic review of the literature. Eur Urol 68:1045–1053

    Article  Google Scholar 

  13. Ahmed HU, El-Shater Bosaily A, Brown LC et al (2017) Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet 389:815–822

    Article  Google Scholar 

  14. Simmons LAM, Kanthabalan A, Arya M et al (2017) The PICTURE study: diagnostic accuracy of multiparametric MRI in men requiring a repeat prostate biopsy. Br J Cancer 116:1159–1165

    Article  Google Scholar 

  15. Schoots IG, Roobol MJ, Nieboer D, Bangma CH, Steyerberg EW, Hunink MG (2015) Magnetic resonance imaging-targeted biopsy may enhance the diagnostic accuracy of significant prostate cancer detection compared to standard transrectal ultrasound-guided biopsy: a systematic review and meta-analysis. Eur Urol 68:438–450

    Article  Google Scholar 

  16. Siddiqui MM, Rais-Bahrami S, Turkbey B et al (2015) Comparison of MR/ultrasound fusion-guided biopsy with ultrasound-guided biopsy for the diagnosis of prostate cancer. JAMA 313:390–397

    Article  CAS  Google Scholar 

  17. van Hove A, Savoie PH, Maurin C et al (2014) Comparison of image-guided targeted biopsies versus systematic randomized biopsies in the detection of prostate cancer: a systematic literature review of well-designed studies. World J Urol 32:847–858

    Article  Google Scholar 

  18. Valerio M, Donaldson I, Emberton M et al (2015) Detection of clinically significant prostate cancer using magnetic resonance imaging-ultrasound fusion targeted biopsy: a systematic review. Eur Urol 68:8–19

    Article  Google Scholar 

  19. Wegelin O, van Melick HHE, Hooft L et al (2017) Comparing three different techniques for magnetic resonance imaging-targeted prostate biopsies: a systematic review of in-bore versus magnetic resonance imaging-transrectal ultrasound fusion versus cognitive registration. is there a preferred technique? Eur Urol 71:517–531

    Article  Google Scholar 

  20. Distler FA, Radtke JP, Bonekamp D et al (2017) The value of PSA density in combination with PI-RADS for the accuracy of prostate cancer prediction. J Urol 198:575–582

    Article  Google Scholar 

  21. Radtke JP, Wiesenfarth M, Kesch C et al (2017) Combined clinical parameters and multiparametric magnetic resonance imaging for advanced risk modeling of prostate cancer-patient-tailored risk stratification can reduce unnecessary biopsies. Eur Urol 72:888–896

    Article  Google Scholar 

  22. van Leeuwen PJ, Hayen A, Thompson JE et al (2017) A multiparametric magnetic resonance imaging-based risk model to determine the risk of significant prostate cancer prior to biopsy. BJU Int 120:774–781

    Article  Google Scholar 

  23. Bjurlin MA, Rosenkrantz AB, Sarkar S et al (2018) Prediction of prostate cancer risk among men undergoing combined MRI-targeted and systematic biopsy using novel pre-biopsy nomograms that incorporate MRI findings. Urology 112:112–120

    Article  Google Scholar 

  24. Mehralivand S, Shih JH, Rais-Bahrami S et al (2018) A magnetic resonance imaging-based prediction model for prostate biopsy risk stratification. JAMA Oncol 4:678–685

    Article  Google Scholar 

  25. Kasivisvanathan V, Rannikko AS, Borghi M et al (2018) MRI-Targeted or Standard Biopsy for Prostate-Cancer Diagnosis. N Engl J Med. 378:1767–1777

    Article  Google Scholar 

  26. Porpiglia F, Manfredi M, Mele F et al (2017) Diagnostic pathway with multiparametric magnetic resonance imaging versus standard pathway: results from a randomized prospective study in biopsy-naive patients with suspected prostate cancer. Eur Urol 72:282–288

    Article  Google Scholar 

  27. Tonttila PP, Lantto J, Paakko E et al (2016) Prebiopsy multiparametric magnetic resonance imaging for prostate cancer diagnosis in biopsy-naive men with suspected prostate cancer based on elevated prostate-specific antigen values: results from a randomized prospective blinded controlled trial. Eur Urol 69:419–425

    Article  Google Scholar 

  28. Baco E, Rud E, Eri LM et al (2016) A randomized controlled trial to assess and compare the outcomes of two-core prostate biopsy guided by fused magnetic resonance and transrectal ultrasound images and traditional 12-core systematic biopsy. Eur Urol 69:149–156

    Article  Google Scholar 

  29. Arsov C, Rabenalt R, Blondin D et al (2015) Prospective randomized trial comparing magnetic resonance imaging (MRI)-guided in-bore biopsy to MRI-ultrasound fusion and transrectal ultrasound-guided prostate biopsy in patients with prior negative biopsies. Eur Urol 68:713–720

    Article  Google Scholar 

  30. Le JD, Tan N, Shkolyar E et al (2015) Multifocality and prostate cancer detection by multiparametric magnetic resonance imaging: correlation with whole-mount histopathology. Eur Urol 67:569–576

    Article  Google Scholar 

  31. Borkowetz A, Platzek I, Toma M et al (2016) Direct comparison of multiparametric magnetic resonance imaging (MRI) results with final histopathology in patients with proven prostate cancer in MRI/ultrasonography-fusion biopsy. BJU Int 118:213–220

    Article  Google Scholar 

  32. Radtke JP, Schwab C, Wolf MB et al (2016) Multiparametric magnetic resonance imaging (MRI) and MRI-transrectal ultrasound fusion biopsy for index tumor detection: correlation with radical prostatectomy specimen. Eur Urol 70:846–853

    Article  Google Scholar 

  33. Arsov C, Becker N, Rabenalt R et al (2015) The use of targeted MR-guided prostate biopsy reduces the risk of Gleason upgrading on radical prostatectomy. J Cancer Res Clin Oncol 141:2061–2068

    Article  CAS  Google Scholar 

  34. Rud E, Baco E, Klotz D et al (2015) Does preoperative magnetic resonance imaging reduce the rate of positive surgical margins at radical prostatectomy in a randomised clinical trial? Eur Urol 68:487–496

    Article  Google Scholar 

  35. Feng TS, Sharif-Afshar AR, Wu J et al (2015) Multiparametric MRI improves accuracy of clinical nomograms for predicting extracapsular extension of prostate cancer. Urology. 86:332–337

    Article  Google Scholar 

  36. Morlacco A, Sharma V, Viers BR et al (2017) The incremental role of magnetic resonance imaging for prostate cancer staging before radical prostatectomy. Eur Urol 71:701–704

    Article  Google Scholar 

  37. Grivas N, Hinnen K, de Jong J et al (2018) Seminal vesicle invasion on multi-parametric magnetic resonance imaging: correlation with histopathology. Eur J Radiol 98:107–112

    Article  Google Scholar 

  38. Tay KJ, Gupta RT, Brown AF, Silverman RK, Polascik TJ (2016) Defining the incremental utility of prostate multiparametric magnetic resonance imaging at standard and specialized read in predicting extracapsular extension of prostate cancer. Eur Urol 70:211–213

    Article  Google Scholar 

  39. Weaver JK, Kim EH, Vetter JM et al (2018) Prostate magnetic resonance imaging provides limited incremental value over the memorial sloan kettering cancer center preradical prostatectomy nomogram. Urology 113:119–128

    Article  Google Scholar 

  40. Giganti F, Coppola A, Ambrosi A et al (2016) Apparent diffusion coefficient in the evaluation of side-specific extracapsular extension in prostate cancer: development and external validation of a nomogram of clinical use. Urol Oncol 34(291):e9–e17

    Google Scholar 

  41. Woo S, Cho JY, Kim SY, Kim SH (2015) Extracapsular extension in prostate cancer: added value of diffusion-weighted MRI in patients with equivocal findings on T2-weighted imaging. AJR Am J Roentgenol 204:W168–W175

    Article  Google Scholar 

  42. Toner L, Papa N, Perera M et al (2017) Multiparametric magnetic resonance imaging for prostate cancer-a comparative study including radical prostatectomy specimens. World J Urol 35:935–941

    Article  CAS  Google Scholar 

  43. Park SY, Jung DC, Oh YT et al (2016) Prostate cancer: PI-RADS version 2 helps preoperatively predict clinically significant cancers. Radiology 280:108–116

    Article  Google Scholar 

  44. Weinreb JC, Barentsz JO, Choyke PL et al (2016) PI-RADS prostate imaging—reporting and data system: 2015, version 2. Eur Urol 69:16–40

    Article  Google Scholar 

  45. Barentsz JO, Richenberg J, Clements R et al (2012) ESUR prostate MR guidelines 2012. Eur Radiol 22:746–757

    Article  Google Scholar 

  46. Schieda N, Quon JS, Lim C et al (2015) Evaluation of the european society of urogenital radiology (ESUR) PI-RADS scoring system for assessment of extra-prostatic extension in prostatic carcinoma. Eur J Radiol 84:1843–1848

    Article  Google Scholar 

  47. Riney JC, Sarwani NE, Siddique S, Raman JD (2018) Prostate magnetic resonance imaging: the truth lies in the eye of the beholder. Urologic oncology. 36(159):e1–e5

    Google Scholar 

  48. Raskolnikov D, George AK, Rais-Bahrami S et al (2015) The Role of Magnetic Resonance Image Guided Prostate Biopsy in Stratifying Men for Risk of Extracapsular Extension at Radical Prostatectomy. J Urol 194:105–111

    Article  Google Scholar 

  49. Wang L, Hricak H, Kattan MW et al (2006) Combined endorectal and phased-array MRI in the prediction of pelvic lymph node metastasis in prostate cancer. AJR Am J Roentgenol 186:743–748

    Article  Google Scholar 

  50. Park SY, Oh YT, Jung DC, Cho NH, Choi YD, Rha KH (2015) Prediction of micrometastasis (< 1 cm) to pelvic lymph nodes in prostate cancer: role of preoperative MRI. AJR Am J Roentgenol 205:W328–W334

    Article  Google Scholar 

  51. Brembilla G, Dell’Oglio P, Stabile A et al (2017) Preoperative multiparametric MRI of the prostate for the prediction of lymph node metastases in prostate cancer patients treated with extended pelvic lymph node dissection. Eur Radiol 28:1969–1976

    Article  Google Scholar 

  52. Porpiglia F, Manfredi M, Mele F et al (2018) Indication to pelvic lymph nodes dissection for prostate cancer: the role of multiparametric magnetic resonance imaging when the risk of lymph nodes invasion according to Briganti updated nomogram is < 5. Prostate cancer prostatic Dis 21:85–91

    Article  Google Scholar 

  53. Park JJ, Kim CK, Park SY, Park BK, Lee HM, Cho SW (2014) Prostate cancer: role of pretreatment multiparametric 3-T MRI in predicting biochemical recurrence after radical prostatectomy. AJR Am J Roentgenol 202:W459–W465

    Article  Google Scholar 

  54. Ho R, Siddiqui MM, George AK et al (2016) Preoperative multiparametric magnetic resonance imaging predicts biochemical recurrence in prostate cancer after radical prostatectomy. PLoS One 11:e0157313

    Article  Google Scholar 

  55. Zhang YD, Wang J, Wu CJ et al (2016) An imaging-based approach predicts clinical outcomes in prostate cancer through a novel support vector machine classification. Oncotarget 7:78140–78151

    PubMed  PubMed Central  Google Scholar 

  56. Zhang YD, Wu CJ, Bao ML et al (2017) MR-based prognostic nomogram for prostate cancer after radical prostatectomy. J Magn Reson Imaging JMRI 45:586–596

    Article  Google Scholar 

  57. Tan N, Shen L, Khoshnoodi P et al (2017) Pathological and 3 Tesla Volumetric Magnetic Resonance Imaging Predictors of Biochemical Recurrence after Robotic Assisted Radical Prostatectomy: Correlation with Whole Mount Histopathology. J Urol 199:1218–1223

    Article  Google Scholar 

Download references

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Author information

Authors and Affiliations

  1. Department of Urology and Division of Experimental Oncology, IRCCS San Raffaele Scientific Institute, Urological Research Institute (URI), Via Olgettina 60, 20132, Milan, Italy

    Paolo Dell’Oglio, Armando Stabile, Giorgio Gandaglia, Elio Mazzone, Nicola Fossati, Vito Cucchiara, Emanuele Zaffuto, Nazareno Suardi, Francesco Montorsi & Alberto Briganti

  2. Department of Urology, OLV Aalst, Aalst, Belgium

    Paolo Dell’Oglio, Brendan Hermenigildo Dias & Alexandre Mottrie

  3. ORSI Academy, Melle, Belgium

    Paolo Dell’Oglio, Brendan Hermenigildo Dias & Alexandre Mottrie

  4. Department of Urology, Federico II University, Naples, Italy

    Vincenzo Mirone

Authors
  1. Paolo Dell’Oglio
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Armando Stabile
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Brendan Hermenigildo Dias
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Giorgio Gandaglia
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Elio Mazzone
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nicola Fossati
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Vito Cucchiara
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Emanuele Zaffuto
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Vincenzo Mirone
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Nazareno Suardi
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Alexandre Mottrie
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Francesco Montorsi
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Alberto Briganti
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

PD: data collection and manuscript writing; AS: data collection and manuscript writing; BHD: data collection and manuscript writing; GG: manuscript editing and critical revision for important intellectual content; EM: manuscript editing and critical revision for important intellectual content; NF: manuscript editing and critical revision for important intellectual content; VC: manuscript editing and critical revision for important intellectual content; EZ: manuscript editing and critical revision for important intellectual content; VM: manuscript editing and critical revision for important intellectual content;NS: supervision and critical revision for important intellectual content; AM: supervision and critical revision for important intellectual content; FM: supervision and critical revision for important intellectual content; AB: supervision, manuscript writing.

Corresponding author

Correspondence to Alberto Briganti.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Dell’Oglio, P., Stabile, A., Dias, B.H. et al. Impact of multiparametric MRI and MRI-targeted biopsy on pre-therapeutic risk assessment in prostate cancer patients candidate for radical prostatectomy. World J Urol 37, 221–234 (2019). https://doi.org/10.1007/s00345-018-2360-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-018-2360-1

Keywords

Search

Navigation