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Il Giornale Italiano di Radiologia Medica 2019 Maggio-Giugno;6(3):197-203

DOI: 10.23736/S2283-8376.19.00209-2

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English, Italian

Increase in the use of multiparametric MRI in prostate cancer patients: the experience of a high-volume center

Caterina GAUDIANO 1 , Beniamino CORCIONI 1, Federica CICCARESE 1, Monica GARATTONI 1, Riccardo SCHIAVINA 2, Francesca GIUNCHI 3, Maria NTRETA 4, Michelangelo FIORENTINO 3, Eugenio BRUNOCILLA 2, Rita GOLFIERI 1

1 Department of Radiology, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; 2 Department of Urology, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; 3 Laboratory of Oncologic Molecular Pathology, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy; 4 Center of Radiation Oncology, St. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy


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BACKGROUND: The aim of this study was to analyze the increase in the use of multiparametric Magnetic Resonance Imaging (mpMRI) in evaluating patients with prostate cancer (PCa).
METHODS: The mpMRIs performed over a period of 25 months were classified according to clinical indications (diagnosis, staging, active surveillance and follow-up after primary treatment). The data were evaluated as follows: the PIRADS (Prostate Imaging Reporting and Data System) v. 2 results for the diagnosis; the presence of extra-capsular extension (ECE) and seminal vesicle infiltration (SVI) for the staging; confirmation of indolent disease or radiological upgrade in active surveillance; the presence of local recurrence in the follow-up. For all these values, the absolute and percentage increases were reported.
RESULTS: A total of 1034 mpMRIs of the prostate were performed with an increase of 341%. The indications were subdivided as follows: diagnosis (73%), staging (9%), active surveillance (13%) and follow-up (5%). For the diagnosis, the results in terms of PIRADS were: categories 1 and 2 (69%), category 3 (19%), categories 4 and 5 (12%). For the staging, ECE was present in 26/94 (28%) and SVI in 10/94 (11%) patients. In active surveillance, mpMRI confirmed indolent disease in 66 of 138 (48%) patients and demonstrated a radiological upgrade in 72 of 138 (52%) patients. For the follow-up, mpMRI showed local recurrence in 20 of 52 (38%) patients.
CONCLUSIONS: The results of this study show a remarkable increase in the use of mpMRI over 25 months for all the clinical indications, especially for diagnosis, for which it is being used more and more as screening, and active surveillance, although its role has not yet been clearly established in this context.


KEY WORDS: Magnetic resonance imaging; Prostatic neoplasms; Watchful waiting

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