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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound
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mpMRI Interpretation in Active Surveillance for Prostate Cancer-An overview of the PRECISE score

Felix N Harder1,2,3, Carolina A M Heming2,3,4, Masoom A Haider5,6

  • 1Institute of Diagnostic and Interventional Radiology, Technical University of Munich, Munich, Germany.

Abdominal Radiology (New York)
|May 9, 2023
PubMed

Insights

Active surveillance for prostate cancer (PCa) may benefit from multiparametric magnetic resonance imaging (mpMRI). The PRECISE scoring system shows potential for guiding serial mpMRI in PCa management.

Area of Science:

  • Oncology
  • Radiology
  • Medical Imaging

Background:

  • Active surveillance (AS) is a standard management strategy for low-risk and selected intermediate-risk prostate cancer (PCa).
  • Multiparametric magnetic resonance imaging (mpMRI) is increasingly utilized in AS protocols, but its role in reducing repeat biopsies requires further clarification.
  • The PRECISE (Prostate Cancer Radiological Estimation of Change in Sequential Evaluation) scoring system was developed to assess radiological progression on serial mpMRI.

Purpose of the Study:

  • To review the current literature on the application of the PRECISE scoring system in active surveillance for prostate cancer.
  • To evaluate the strengths and potential added value of the PRECISE system in mpMRI reporting for AS.
  • To identify weaknesses of the PRECISE system and suggest areas for future improvement.

Main Methods:

  • Systematic review of published studies evaluating the PRECISE scoring system in the context of prostate cancer active surveillance.
  • Analysis of the literature focusing on the utility of PRECISE in assessing radiological tumor progression on serial mpMRI.
  • Discussion of the strengths, weaknesses, and potential future development of the PRECISE scoring system.

Main Results:

  • The PRECISE scoring system is the only major system evaluated in multiple publications for assessing radiological progression in AS.
  • Evidence suggests potential benefits of the PRECISE system in guiding serial mpMRI interpretation within AS protocols.
  • Uncertainty persists regarding the definitive impact of serial mpMRI, guided by PRECISE, on reducing repeat biopsies.

Conclusions:

  • The PRECISE scoring system shows promise as a tool for managing prostate cancer active surveillance using serial mpMRI.
  • Further research and refinement of the PRECISE system are needed to establish it as a standard in mpMRI reporting for AS.
  • Addressing current weaknesses in the PRECISE scoring system could enhance its value and facilitate safer reduction of repeat biopsies in AS.
Keywords:
Active surveillanceMRIPRECISEProstate cancer

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