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Review
. 2024 Apr 12:4:1329274.
doi: 10.3389/fruro.2024.1329274. eCollection 2024.

The evolving landscape: magnetic resonance imaging in active surveillance for prostate cancer management

Irene De la Parra  1 , Juan Gómez Rivas  1 , Beatriz Gutiérrez  1 , María Jesús Marugán  1 , Dmitry Enikeev  2 , Bhaskar K Somani  3 , Jerónimo Barrera  4 , Jesús Moreno-Sierra  1
Affiliations
Review

The evolving landscape: magnetic resonance imaging in active surveillance for prostate cancer management

Irene De la Parra et al. Front Urol. .

Abstract

Since overdiagnosis and overtreatment pose significant risks in managing prostate cancer (PCa), active surveillance (AS) is the most common treatment in low-risk patients. However, there is no general agreement yet on the inclusion criteria and the required follow-up. Multiparametric magnetic resonance imaging (mpMRI) of the prostate was born as a useful device in these patients both in diagnosis and follow-up, and it is widely used in daily clinical practice. We reflect on the most current evidence described in the literature on the topic, its results, and our experience.

Keywords: PRECISE; active surveillance; magnetic resonance imaging; overdiagnosis; overtreatment; prostate cancer.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
A PI-RADS 4 lesion on the posterior peripheric area of the prostate. (A) Axial T2-weighted sequence: T2 hypointense lesion on the posterior peripheric area of the prostate. (B) Axial diffusion-weighted sequence (ADC maps): focal restricted diffusion lesion. (C) Dynamic contrast-enhanced sequence (functional T1 perfusion maps) with early enhancement and contrast washout of the lesion.
Figure 2
Figure 2
(A) Axial T2-weighted image with a hypointense lesion on the anterior transitional zone of the middle third bilaterally. (B) Axial diffusion-weighted image (ADC maps) with a marked diffusion restriction on the same zone. PI-RADS 5.
Figure 3
Figure 3
(A, B) Diffusion-weighted image (ADC maps). Marked diffusion restriction lesion on the posteromedial peripheric zone of the right middle third. The same lesion presents more diffusion restriction and has grown from (A, B).
See this image and copyright information in PMC

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