Cancer Management and Research (Mar 2022)
Current Opinion on the Use of Magnetic Resonance Imaging in Staging Prostate Cancer: A Narrative Review
Abstract
Jamie Michael,1 Kevin Neuzil,2 Ersan Altun,3 Marc A Bjurlin2,4 1University of North Carolina, School of Medicine, Chapel Hill, NC, USA; 2Department of Urology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 3Department of Radiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; 4Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USACorrespondence: Marc A Bjurlin, Associate Professor, Department of Urology, Lineberger Comprehensive Cancer Center, University of North Carolina, 101 Manning Drive, 2nd Floor, Chapel Hill, NC, USA, Email [email protected]: Accurate staging is critical for treatment planning and prognosis in men with prostate Cancer. Prostate magnetic imaging resonance (MRI) may aid in the staging evaluation by verifying organ-confined status, assessing the status of the pelvic lymph nodes, and establishing the local extent of the tumor in patients being considered for therapy. MRI has a high specificity for diagnosing extracapsular extension, and therefore may impact the decision to perform nerve sparing prostatectomy, along with seminal vesicle invasion and lymph node metastases; however, its sensitivity remains limited. Current guidelines vary significantly regarding endorsing the use of MRI for staging locoregional disease. For high-risk prostate cancer, most guidelines recommend cross sectional imaging, including MRI, to evaluate for more extensive disease that may merit change in radiation field, extended androgen deprivation therapy, or guiding surgical planning. Although MRI offers reasonable performance characteristics to evaluate bone metastases, guidelines continue to support the use of bone scintigraphy. Emerging imaging technologies, including coupling positron emission tomography (PET) with MRI, have the potential to improve the accuracy of prostate cancer staging with the use of novel radiotracers.Keywords: prostate cancer, magnetic resonance imaging, staging
