PRECISE Version 2: Essential Tips for Prostate Cancer Monitoring Using MRI

Area of Science:

• Radiology
• Oncology
• Urology

Background:

• Active surveillance (AS) is a key strategy for managing low-risk prostate cancer, aiming to prevent overtreatment.
• Magnetic Resonance Imaging (MRI) is crucial in AS for risk stratification, identifying significant disease, and guiding biopsies.
• Serial MRI evaluations are essential for monitoring disease stability or progression during AS.

Purpose of the Study:

• To review the rationale and criteria for patient selection in active surveillance protocols.
• To discuss the evolution and application of the PRECISE (Prostate Cancer Radiologic Estimation of Change in Sequential Evaluation) system for serial MRI.
• To demonstrate the integration of clinical and MRI findings using practical cases.

Main Methods:

• Review of active surveillance protocols and the role of MRI.
• Explanation of the PRECISE criteria, including version 2 updates and its Likert scoring system.
• Presentation of clinical cases illustrating the application of PRECISE criteria in AS.

Main Results:

• PRECISE version 2 provides simplified guidelines for assessing longitudinal MRI changes in prostate cancer.
• The system focuses on lesion size, appearance, and new lesion development.
• A 1-5 Likert scoring system standardizes communication regarding MRI changes over time.

Conclusions:

• The PRECISE criteria version 2 enhances standardized reporting for serial MRI in prostate cancer active surveillance.
• This structured approach aids in assessing disease progression and informing treatment strategy adjustments.
• Effective integration of MRI findings with clinical data is vital for optimal AS management.