Multi-parametric MRI may be a substitute for serial biopsies in active surveillance regimens to avoid patient discomfort associated with repeat biopsies.
Magnetic resonance imaging may help monitor men with prostate cancer who are under active surveillance, according to a study published in the American Journal of Roentgenology. Researchers from Winthrop University Hospital, Mineola, N.Y., performed a study to report the multi-parametric MRI characteristics of prostate cancer patients who discontinued active surveillance after repeat imaging revealed possible evidence of tumor upgrading. Two hundred patients with prostate cancer were being monitored with active surveillance; 114 patients had undergone an initial multi-parametric MRI study before active surveillance started and at least one follow-up multi-parametric MRI study performed after active surveillance began. The MRI findings were evaluated and correlated with pathology results, if available. The results showed that 14 patients discontinued active surveillance because changes on follow-up MRI suggested progression of cancer. Follow-up MRI showed: • Enlarged or more prominent lesion compared with the appearance on a previous MRI in three (21.4 percent) patients;• New lesion or lesions suspicious for cancer in two (14.3 percent) patients; and • Findings suspicious for or confirming extracapsular extension in nine (64.3 patients) patients. Seven of the 14 (50.0 percent) patients had a biopsy after follow-up multi-parametric MRI, and biopsy results led to tumor upgrading in six of the 14 (42.9 percent) patients. The duration of active surveillance ranged from 4 to 110 months. All patients received definitive treatment. The researchers concluded the small number of patients with follow-up multi-parametric MRI findings showing worsening disease supports the role of MRI in patients with early-stage prostate cancer. Multi-parametric MRI is useful in monitoring patients on active surveillance and may identify patients with clinically significant cancer amenable to definitive treatment.
Multicenter CT Study Shows Benefits of Emerging Diagnostic Model for Clear Cell Renal Cell Carcinoma
May 15th 2024Combining clinical and CT features, adjunctive use of a classification and regression tree (CART) diagnostic model demonstrated AUCs for detecting clear cell renal cell carcinoma (ccRCC) that were 15 to 22 percent higher than unassisted radiologist assessments.
Current Insights and Emerging Roles for Contrast-Enhanced Mammography
May 10th 2024In a recent lecture at the 2024 ARRS Annual Meeting, Jordana Phillips, MD, discussed the role of contrast-enhanced mammography in staging breast cancer, evaluating response to neoadjuvant chemotherapy and recalls from screening.
MRI-Based Deep Learning Algorithm Shows Comparable Detection of csPCa to Radiologists
May 8th 2024In a study involving over 1,000 visible prostate lesions on biparametric MRI, a deep learning algorithm detected 96 percent of clinically significant prostate cancer (csPCa) in comparison to a 98 percent detection rate for an expert genitourinary radiologist.