Contemporary Prostate Cancer Intraprostatic Imaging Scores: A Practical and Hands-on Guide for Urologists.

Area of Science:

• Radiology and Oncology
• Medical Imaging
• Prostate Cancer Diagnostics

Background:

• Prostate cancer (PCa) management relies heavily on imaging for diagnosis, staging, and follow-up.
• Standardized interpretation of imaging findings is crucial for consistent clinical decision-making.
• Various imaging modalities, including MRI, PSMA-PET, and ultrasound, are employed in PCa assessment.

Purpose of the Study:

• To review and summarize current evidence on intraprostatic imaging scoring systems for MRI, PSMA-PET, and ultrasound.
• To provide a practical guide for the interpretation and routine clinical use of these scoring systems.
• To enhance clinical decision-making and patient management in prostate cancer.

Main Methods:

• Mini-review of existing literature on prostate cancer imaging scoring systems.
• Focus on systems for MRI (e.g., PIRADS, PICASSO, PI-MRF, PIRADS), PSMA-PET (PRIMARY scores), and micro-ultrasound (PROMIS score).
• Synthesis of practical insights for clinical application.

Main Results:

• Multiple scoring systems exist for different stages and modalities of PCa imaging.
• Established systems like PIRADS are vital for diagnosis, while others address active surveillance, post-therapy evaluation, and recurrence.
• Emerging scoring systems for PSMA-PET and micro-ultrasound facilitate interpretation of newer technologies.

Conclusions:

• Standardized scoring systems are essential for consistent and accurate interpretation of PCa imaging across modalities.
• These tools improve diagnostic accuracy, guide treatment decisions, and support patient monitoring.
• Understanding and applying these scoring systems optimizes prostate cancer management.