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      ESUR prostate MR guidelines 2012

      case-report

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          Abstract

          The aim was to develop clinical guidelines for multi-parametric MRI of the prostate by a group of prostate MRI experts from the European Society of Urogenital Radiology (ESUR), based on literature evidence and consensus expert opinion. True evidence-based guidelines could not be formulated, but a compromise, reflected by “minimal” and “optimal” requirements has been made. The scope of these ESUR guidelines is to promulgate high quality MRI in acquisition and evaluation with the correct indications for prostate cancer across the whole of Europe and eventually outside Europe. The guidelines for the optimal technique and three protocols for “detection”, “staging” and “node and bone” are presented. The use of endorectal coil vs. pelvic phased array coil and 1.5 vs. 3 T is discussed. Clinical indications and a PI-RADS classification for structured reporting are presented.

          Key Points

          • This report provides guidelines for magnetic resonance imaging (MRI) in prostate cancer.

          • Clinical indications, and minimal and optimal imaging acquisition protocols are provided.

          • A structured reporting system (PI-RADS) is described.

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          Most cited references77

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          Cancer statistics, 2009.

          A. Jemal, R. Siegel, E. Ward … (2009)
          Each year, the American Cancer Society estimates the number of new cancer cases and deaths expected in the United States in the current year and compiles the most recent data on cancer incidence, mortality, and survival based on incidence data from the National Cancer Institute, Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries and mortality data from the National Center for Health Statistics. Incidence and death rates are standardized by age to the 2000 United States standard million population. A total of 1,479,350 new cancer cases and 562,340 deaths from cancer are projected to occur in the United States in 2009. Overall cancer incidence rates decreased in the most recent time period in both men (1.8% per year from 2001 to 2005) and women (0.6% per year from 1998 to 2005), largely because of decreases in the three major cancer sites in men (lung, prostate, and colon and rectum [colorectum]) and in two major cancer sites in women (breast and colorectum). Overall cancer death rates decreased in men by 19.2% between 1990 and 2005, with decreases in lung (37%), prostate (24%), and colorectal (17%) cancer rates accounting for nearly 80% of the total decrease. Among women, overall cancer death rates between 1991 and 2005 decreased by 11.4%, with decreases in breast (37%) and colorectal (24%) cancer rates accounting for 60% of the total decrease. The reduction in the overall cancer death rates has resulted in the avoidance of about 650,000 deaths from cancer over the 15-year period. This report also examines cancer incidence, mortality, and survival by site, sex, race/ethnicity, education, geographic area, and calendar year. Although progress has been made in reducing incidence and mortality rates and improving survival, cancer still accounts for more deaths than heart disease in persons younger than 85 years of age. Further progress can be accelerated by applying existing cancer control knowledge across all segments of the population and by supporting new discoveries in cancer prevention, early detection, and treatment.
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            The diagnostic accuracy of CT and MRI in the staging of pelvic lymph nodes in patients with prostate cancer: a meta-analysis.

            A. Hövels, R A M Heesakkers, E. M. Adang … (2008)
            To compare the diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI) in the diagnosis of lymph node metastases in prostate cancer. After a comprehensive literature search, studies were included that allowed construction of contingency tables for detection of lymph node metastases using CT or MRI. In addition, a summary receiver-operating characteristic (ROC) analysis was performed. A total of 24 studies were included. For CT, pooled sensitivity was 0.42 (0.26-0.56 95% CI) and pooled specificity was 0.82 (0.8-0.83 95% CI). For MRI, the pooled sensitivity was 0.39 (0.22-0.56 95% CI) and pooled specificity was 0.82 (0.79-0.83 95% CI). The differences in performance of CT and MRI were not statistically significant. CT and MRI demonstrate an equally poor performance in the detection of lymph node metastases from prostate cancer. Reliance on either CT or MRI will misrepresent the patient's true status regarding nodal metastases, and thus misdirect the therapeutic strategies offered to the patient.
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              Relationship between apparent diffusion coefficients at 3.0-T MR imaging and Gleason grade in peripheral zone prostate cancer.

              Diederik Somford, Thomas Hambrock, J. Barentsz … (2011)
              To retrospectively determine the relationship between apparent diffusion coefficients (ADCs) obtained with 3.0-T diffusion-weighted (DW) magnetic resonance (MR) imaging and Gleason grades in peripheral zone prostate cancer. The requirement to obtain institutional review board approval was waived. Fifty-one patients with prostate cancer underwent MR imaging before prostatectomy, including DW MR imaging with b values of 0, 50, 500, and 800 sec/mm(2). In prostatectomy specimens, separate slice-by-slice determinations of Gleason grade groups were performed according to primary, secondary, and tertiary Gleason grades. In addition, tumors were classified into qualitative grade groups (low-, intermediate-, or high-grade tumors). ADC maps were aligned to step-sections and regions of interest annotated for each tumor slice. The median ADC of tumors was related to qualitative grade groups with linear mixed-model regression analysis. The accuracy of the median ADC in the most aggressive tumor component in the differentiation of low- from combined intermediate- and high-grade tumors was summarized by using the area under the receiver operating characteristic (ROC) curve (A(z)). In 51 prostatectomy specimens, 62 different tumors and 251 step-section tumor lesions were identified. The median ADC in the tumors showed a negative relationship with Gleason grade group, and differences among the three qualitative grade groups were statistically significant (P < .001). Overall, with an increase of one qualitative grade group, the median ADC (±standard deviation) decreased 0.18 × 10(-3) mm(2)/sec ± 0.02. Low-, intermediate-, and high-grade tumors had a median ADC of 1.30 × 10(-3) mm(2)/sec ± 0.30, 1.07 × 10(-3) mm(2)/sec ± 0.30, and 0.94 × 10(-3) mm(2)/sec ± 0.30, respectively. ROC analysis showed a discriminatory performance of A(z) = 0.90 in discerning low-grade from combined intermediate- and high-grade lesions. ADCs at 3.0 T showed an inverse relationship to Gleason grades in peripheral zone prostate cancer. A high discriminatory performance was achieved in the differentiation of low-, intermediate-, and high-grade cancer. RSNA, 2011
              Article 0 comments Cited 123 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                : j.barentsz@rad.umcn.nl
                Journal
                Journal ID (nlm-ta): Eur Radiol
                Title: European Radiology
                Publisher: Springer-Verlag (Berlin/Heidelberg )
                ISSN (Print): 0938-7994
                ISSN (Electronic): 1432-1084
                Publication date (Electronic): 10 February 2012
                Publication date PMC-release: 10 February 2012
                Publication date (Print): April 2012
                Volume: 22
                Issue: 4
                Pages: 746-757
                Affiliations
                [1 ]Department of Radiology, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
                [2 ]Brighton & Sussex University Hospital Trust, Eastern Road, Brighton, UK
                [3 ]Department of Clinical Radiology, Royal Gwent Hospital, Newport, South Wales UK
                [4 ]Molecular Imaging Program, National Cancer Institute, Bethesda, MD USA
                [5 ]University Of Cincinnati Medical Center, Cincinnati, OH USA
                [6 ]Division of Genitourinary Radiology, Ghent University Hospital, Ghent, Belgium
                [7 ]Hospices Civils de Lyon, Department of Urinary and Vascular Imaging, Hôpital Edouard Herriot, Lyon, France
                [8 ]Université de Lyon, Lyon, France
                [9 ]Faculté de Médecine Lyon Est, Université Lyon 1, Lyon, France
                [10 ]Copenhagen University, Hospital Herlev, Herlev, Denmark
                Article
                Publisher ID: 2377
                DOI: 10.1007/s00330-011-2377-y
                PMC ID: 3297750
                PubMed ID: 22322308
                SO-VID: 7bdabc41-d375-474e-939e-de3b5f649a87
                Copyright © © The Author(s) 2012
                History
                Date received : 16 October 2011
                Date revision received : 23 November 2011
                Date accepted : 2 December 2011
                Categories
                Subject: Urogenital
                Custom metadata
                issue-copyright-statement © European Society of Radiology 2012

                ScienceOpen disciplines: Radiology & Imaging
                Keywords: oncology,guidelines,mri,prostate cancer,esur
                Data availability:
                ScienceOpen disciplines: Radiology & Imaging
                Keywords: oncology, guidelines, mri, prostate cancer, esur

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