title: Role of multiparametric magnetic resonance imaging in early detection of prostate cancer.
abstract: Most prostate cancers (PC) are currently found on the basis of an elevated PSA, although this biomarker has only moderate accuracy. Histological confirmation is traditionally obtained by random transrectal ultrasound guided biopsy, but this approach may underestimate PC. It is generally accepted that a clinically significant PC requires treatment, but in case of an non-significant PC, deferment of treatment and inclusion in an active surveillance program is a valid option. The implementation of multiparametric magnetic resonance imaging (mpMRI) into a screening program may reduce the risk of overdetection of non-significant PC and improve the early detection of clinically significant PC. A mpMRI consists of T2-weighted images supplemented with diffusion-weighted imaging, dynamic contrast enhanced imaging, and/or magnetic resonance spectroscopic imaging and is preferably performed and reported according to the uniform quality standards of the Prostate Imaging Reporting and Data System (PIRADS). International guidelines currently recommend mpMRI in patients with persistently rising PSA and previous negative biopsies, but mpMRI may also be used before first biopsy to improve the biopsy yield by targeting suspicious lesions or to assist in the selection of low-risk patients in whom consideration could be given for surveillance.
  
  
  CONCLUSIONS
  • MpMRI may be used to detect or exclude significant prostate cancer. • MpMRI can guide targeted rebiopsy in patients with previous negative biopsies. • In patients with negative mpMRI consideration could be given for surveillance. • MpMRI may add valuable information for the optimal treatment selection.
authors: Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium. pieter.devisschere@uzgent.be.
authors: Pieter J L
authors: PJ
authors: De Visschere
authors: Department of Urology, Urological Research Institute, Vita-Salute University San Raffaele, Milan, Italy.
authors: Alberto
authors: A
authors: Briganti
authors: Department of Radiology and Nuclear Medicine, Radboud UMC, Nijmegen, The Netherlands.
authors: Jurgen J
authors: JJ
authors: Fütterer
authors: Department of Radiation Oncology, Charité Universitätsmedizin Berlin, Berlin, Germany.
authors: Pirus
authors: P
authors: Ghadjar
authors: Department of Urology, Regio Clinic Wedel, Wedel, Germany.|Department of Urology, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
authors: Hendrik
authors: H
authors: Isbarn
authors: Department of Oncology, Institut Gustave Roussy, University of Paris Sud, Villejuif, France.
authors: Christophe
authors: C
authors: Massard
authors: Department of Radiation Oncology and Experimental Cancer Research, Ghent University Hospital, Ghent, Belgium.
authors: Piet
authors: P
authors: Ost
authors: Surgical Intervention Trials Unit, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.|Department of Molecular Medicine & Surgery, Karolinska Institutet, Stockholm, Sweden.
authors: Prasanna
authors: P
authors: Sooriakumaran
authors: Centre of Urological Surgery, Dialysis and Renal Transplantation, Fundeni Clinical Institute, Bucharest, Romania.
authors: Cristian I
authors: CI
authors: Surcel
authors: Department of Urology, CHUV, Lausanne, Switzerland.
authors: Massimo
authors: M
authors: Valerio
authors: Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors: Roderick C N
authors: RC
authors: van den Bergh
authors: Urology Department, Saint Jean Languedoc Hospital, Toulouse, France.|Research Unit INSERM U955, Paris Est University, Team 7, Paris, France.
authors: Guillaume
authors: G
authors: Ploussard
authors: Urology Unit, Academic Medical Centre Hospital «Santa Maria della Misericordia», Udine, Italy.
authors: Gianluca
authors: G
authors: Giannarini
authors: Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
authors: Geert M
authors: GM
authors: Villeirs
keywords: Diffusion magnetic resonance imaging; Magnetic resonance imaging; Magnetic resonance spectroscopy; Prostate; Prostatic neoplasms