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

Arthur Ogata1, Giorgio Brembilla2, Adriano B Dias3

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Active surveillance for prostate cancer uses MRI to monitor disease progression. The PRECISE criteria version 2 offers a standardized MRI evaluation system to guide treatment decisions and avoid overtreatment.

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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.