An update on imaging techniques to optimize active surveillance in prostate cancer

Area of Science:

• Urology
• Radiology
• Oncology

Background:

• Active surveillance (AS) for prostate cancer requires accurate patient selection and reliable follow-up methods.
• Current diagnostic methods, including transrectal ultrasound (TRUS)-guided biopsies, have limitations in accuracy and invasiveness.
• Advances in imaging are crucial for refining AS protocols and improving patient management.

Purpose of the Study:

• To review the impact of multiparametric MRI (mpMRI) on improving diagnostic accuracy and follow-up in prostate cancer AS.
• To explore technical advances in transrectal ultrasound (TRUS) imaging for enhancing biopsy diagnostic accuracy.
• To reduce the number of biopsies and the detection rate of clinically insignificant prostate cancers.

Main Methods:

• Review of multiparametric prostate MRI (mpMRI) applications in AS.
• Discussion of technical advancements in transrectal ultrasound (TRUS) imaging.
• Analysis of how imaging improves patient selection, confirmation, and follow-up in AS protocols.

Main Results:

• mpMRI provides significant diagnostic improvements by assessing tumor size, location, and aggressiveness.
• MRI is a reliable non-invasive technique for excluding clinically significant cancer in AS patients.
• Technical advances in TRUS aim to improve biopsy accuracy, accessibility, and real-time application.

Conclusions:

• Multiparametric MRI (mpMRI) is a key tool for enhancing prostate cancer active surveillance (AS) protocols.
• Improved imaging techniques increase diagnostic accuracy, enabling better patient selection and follow-up.
• Advancements in TRUS and mpMRI reduce the need for repeat biopsies and improve the detection of significant cancers.