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Related Concept Videos

Imaging Studies IV: Magnetic Resonance Imaging01:27

Imaging Studies IV: Magnetic Resonance Imaging

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Introduction:Magnetic Resonance Imaging, or MRI, can include a specialized imaging technique of the urinary system known as Magnetic Resonance Urography (MRU). This radiation-free technique uses strong magnetic fields and radio waves to produce detailed images with the help of a computer. MRU is particularly effective for visualizing fluid-filled structures like the kidneys, ureters, and bladder.Applications of MRI in the Genitourinary SystemKidneys and Ureters: MRI detects tumors, cysts,...
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Magnetic resonance imaging (MRI) is a noninvasive medical imaging technique based on a phenomenon of nuclear physics discovered in the 1930s, in which matter exposed to magnetic fields and radio waves was found to emit radio signals. In 1970, a physician and researcher named Raymond Damadian noticed that malignant (cancerous) tissue gave off different signals than normal body tissue. He applied for a patent for the first MRI scanning device in clinical use by the early 1980s. The early MRI...
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Updated: Sep 20, 2025

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Magnetic Resonance Imaging-led Risk-adapted Active Surveillance for Prostate Cancer: Updated Results from a Large

Cameron Englman1, Busola Adebusoye2, Davide Maffei3

  • 1Division of Surgery & Interventional Science, University College London, London, UK; Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK.

European Urology
|May 28, 2025
PubMed
Summary

Magnetic resonance imaging (MRI)-led active surveillance (AS) for prostate cancer effectively monitors patients. MRI visibility and Gleason pattern 4 at baseline predict progression, guiding treatment decisions for better outcomes.

Keywords:
Active surveillanceProstate cancerProstate magnetic resonance imaging

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Area of Science:

  • Oncology
  • Radiology
  • Urology

Background:

  • Active surveillance (AS) for prostate cancer relies on prostate-specific antigen (PSA) and MRI monitoring.
  • Biopsies are performed only when indicated by PSA density or MRI changes.

Purpose of the Study:

  • To evaluate the effectiveness of MRI-led AS in prostate cancer management.
  • To identify predictors of disease progression during AS.

Main Methods:

  • A cohort of 1150 patients with low-risk prostate cancer (Gleason score ≤3 + 4, PSA <20 ng/ml) on AS between 2000-2023 was analyzed.
  • Patients had at least two MRI scans; event-free survival (EFS) was defined as histological upgrade (GS ≥4 + 3) or treatment initiation.
  • Risk stratification was based on baseline MRI visibility and Gleason pattern 4, with Kaplan-Meier curves used for comparison.

Main Results:

  • At 5 years, EFS rates varied: 91% for non-visible GS 3 + 3, 71% for MRI-visible GS 3 + 3, 70% for non-visible GS 3 + 4, and 44% for MRI-visible GS 3 + 4.
  • Histological upgrade to GS ≥4 + 3 occurred in 67 patients (6%).
  • Progression to metastases was rare and occurred only in patients who missed recommended follow-up MRIs or biopsies.

Conclusions:

  • MRI visibility and the presence of Gleason pattern 4 at baseline are significant predictors of progression during MRI-led AS.
  • These factors are associated with both progression to primary Gleason pattern 4 and the need for treatment.