Standardizing Prostate MRI Reporting in Active Surveillance for Prostate Cancer: The PRECISE Framework

Area of Science:

• Radiology
• Oncology
• Urology

Background:

• Active surveillance (AS) is standard for low-risk prostate cancer, but repeated biopsies carry risks.
• Multiparametric MRI (mpMRI) offers noninvasive monitoring, but lacks standardized longitudinal interpretation.
• The Prostate Imaging Reporting and Data System (PI-RADS) has limitations in assessing serial MRI changes.

Purpose of the Study:

• To review the development and clinical implications of the Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) framework.
• To highlight the advancements in PRECISE v2 for standardized reporting of serial mpMRI in prostate cancer.
• To discuss the potential of PRECISE in improving risk-adapted management for patients on active surveillance.

Main Methods:

• Review of the evolution of the PRECISE framework from v1 to v2.
• Analysis of PRECISE v2 features including imaging quality assessment and progression criteria.
• Synthesis of literature on the clinical utility and impact of PRECISE on AS management.

Main Results:

• The PRECISE framework standardizes serial MRI interpretation using a 5-point scale.
• PRECISE v2 enhances consistency, communication, and timely intervention in AS.
• Updated criteria in PRECISE v2 allow for more personalized follow-up strategies.

Conclusions:

• The PRECISE framework, particularly v2, significantly advances standardized MRI reporting for prostate cancer.
• PRECISE facilitates risk-adapted management and personalized follow-up for patients undergoing active surveillance.
• Further research is needed to fully integrate PRECISE into routine clinical practice and evaluate long-term outcomes.