Objective:
Multiparametric Magnetic Resonance Imaging (mpMRI) has become a very useful tool in
the management of PCa. Particularly, there is a great interest in using mpMRI for men on Active Surveillance
(AS) for low risk PCa. The aim of this systematic review was to critically review the latest literature concerning
the role of mpMRI in this clinical setting, underlying current strengths and weakness.
Evidence Acquisition:
A comprehensive literature research for English-language original and review articles
was carried out using the National Center for Biotechnology Information PubMed database with the aim to
identify studies pertaining to mpMRI for AS in low risk PCa patients. The following search terms were used:
active surveillance, prostate cancer and multiparametric magnetic resonance imaging.
Evidence Synthesis:
Data from 28 recent original studies and reviews were reviewed. We only considered studies
on the use of mpMRI in selecting AS patients and during AS follow-up, in order to solve two important
questions: -Can mpMRI have a role in improving the detection of clinically significant disease, better selecting
AS patients? -Can mpMRI identify the progression of disease and, consequently, be used during AS follow-up?
Conclusions:
mpMRI is useful to better select the ideal candidates to AS and to monitor them during follow-up.
However, despite many advantages, there are yet important limitations to detect all clinically significant PCa
and to better define mpMRI-radiological progression during AS. Further larger prospective studies are needed to
definitively solve these important problems.
The emerging role of imaging in prostate cancer secondary screening: multiparametric magnetic resonance imaging and the incipient incorporation of molecular imaging