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Post-Treatment Imaging in Focal Therapy: Understanding TARGET and PI-FAB Scoring Systems.

Haidy Megahed1, Samuel Tremblay1, Jason Koehler2

  • 1Section of Urology, Department of Surgery, University of Chicago, Chicago, IL 60637, USA.

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|June 13, 2025
PubMed
Summary

New MRI scoring systems, TARGET and PI-FAB, improve prostate cancer (PCa) monitoring after focal therapy (FT). These systems help distinguish benign changes from recurrence, enhancing patient management and treatment decisions.

Keywords:
MRI scoringPI-FABTARGETfocal therapyprostate cancer

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Area of Science:

  • Oncology
  • Radiology
  • Medical Imaging

Background:

  • Focal therapy (FT) for prostate cancer (PCa) is increasingly adopted.
  • Accurate post-treatment imaging is crucial for monitoring outcomes and detecting residual or recurrent cancer.
  • Traditional systems like PI-RADS are inadequate for post-FT evaluation due to treatment-induced tissue changes.

Purpose of the Study:

  • To review and compare two novel MRI-based scoring systems for post-FT prostate cancer evaluation: TARGET and PI-FAB.
  • To highlight the importance of specialized scoring systems in distinguishing benign post-treatment changes from cancer recurrence.
  • To assess the potential of these systems in improving diagnostic accuracy and guiding clinical decisions in PCa management.

Main Methods:

  • Review of existing literature on MRI-based scoring systems for post-focal therapy prostate cancer.
  • Description and comparison of the TARGET and PI-FAB scoring systems.
  • Analysis of their utility in standardizing imaging assessments and clinical decision-making.

Main Results:

  • TARGET and PI-FAB are MRI-based scoring systems developed to address the limitations of traditional systems in the post-FT setting.
  • These systems aim to improve imaging accuracy by differentiating benign post-treatment alterations from cancer recurrence.
  • They offer a standardized approach to imaging assessment for enhanced follow-up care.

Conclusions:

  • TARGET and PI-FAB represent significant advancements in managing prostate cancer patients undergoing focal therapy.
  • These scoring systems have the potential to optimize PCa management by improving diagnostic accuracy and guiding treatment decisions.
  • Further large-scale validation is necessary to confirm the clinical utility of TARGET and PI-FAB.