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Related Experiment Video

Updated: Nov 29, 2025

A New Technique for Treating Low-risk Prostate Cancer—Super Active Surveillance
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Selecting Patients with Favorable Risk, Grade Group 2 Prostate Cancer for Active Surveillance-Does Magnetic Resonance

T Stonier1,2, A L Tin3, D D Sjoberg3

  • 1Department of Surgery (Urology Service), Memorial Sloan Kettering Cancer Center, New York, New York.

The Journal of Urology
|November 20, 2020
PubMed
Summary

Multiparametric MRI can help identify men with grade group 2 prostate cancer suitable for active surveillance. Positive MRI findings correlate with adverse pathology, aiding in treatment selection for favorable-risk patients.

Keywords:
magnetic resonance imagingprognosisprostatic neoplasmswatchful waiting

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Area of Science:

  • Urology
  • Oncology
  • Radiology

Background:

  • Active surveillance is recommended for selected men with grade group 2 prostate cancer.
  • Patient selection for active surveillance in this group remains challenging.

Purpose of the Study:

  • To evaluate if multiparametric MRI (mpMRI) can predict adverse pathology in men with favorable-risk grade group 2 prostate cancer.
  • To assess mpMRI's utility in selecting candidates for active surveillance.

Main Methods:

  • Retrospective analysis of 1,117 patients with favorable risk grade group 2 prostate cancer who underwent radical prostatectomy.
  • Preoperative mpMRI scored as negative, positive, or equivocal.
  • Multivariable logistic regression used to model the association between mpMRI score and adverse pathology.

Main Results:

  • Positive mpMRI was significantly associated with higher rates of adverse pathology (OR 2.55) and upgrading (OR 3.89).
  • Incorporating mpMRI data improved prediction models.
  • An identifiable lesion on mpMRI indicated an increased risk of aggressive features.

Conclusions:

  • Multiparametric MRI offers improved risk prediction for prostate cancer compared to existing methods.
  • Positive mpMRI findings in favorable-risk grade group 2 prostate cancer suggest a higher likelihood of adverse pathology.
  • mpMRI can aid in selecting patients for active surveillance and guide biopsy and surveillance strategies.