PRECISE Version 2: Updated Recommendations for Reporting Prostate Magnetic Resonance Imaging in Patients on Active...

Area of Science:

• Radiology
• Oncology
• Medical Imaging

Background:

• Prostate cancer active surveillance (AS) requires standardized MRI reporting.
• The PRECISE recommendations aim to improve consistency in prostate MRI analysis for AS.
• Recent updates to PRECISE recommendations address areas of uncertainty.

Purpose of the Study:

• To update and refine the PRECISE recommendations for prostate MRI in AS.
• To establish international expert consensus on standardized reporting criteria.
• To identify and address ambiguities in current PRECISE guidelines.

Main Methods:

• Formal RAND/UCLA Appropriateness Method consensus methodology was employed.
• A panel of 38 international experts scored 193 statements on a 1-9 agreement scale.
• Consensus was determined using the Interpercentile Range Adjusted for Symmetry method.

Main Results:

• Agreement was reached on minimum image quality standards and comparison with prior scans.
• PRECISE 3 (stable MRI) was subdivided into visible and non-visible disease categories.
• Consensus was achieved on measuring lesions using T2-weighted imaging and pictorial reporting, but not on tumor size measurement.

Conclusions:

• The updated PRECISE recommendations provide expert consensus on minimal standards for prostate MRI in AS.
• These updated guidelines enhance the standardization of prostate MRI reporting for patients on active surveillance.
• Further research is needed to define significant tumor size increase for monitoring treatment response.