Are “manograms” a viable option in prostate cancer screening and risk assessment?

For several years, Dr. Jelle Barentz in the Netherlands has been a prominent advocate for the idea that we might be able to use imaging methodologies (prostate “manograms”, like breast mammograms for women) to screen for risk of prostate cancer — either along with or instead of PSA testing. … READ MORE …

Can MRI data improve older, pre-treatment, prognostic methods?

An obvious but previously unanswered question has been whether adding data from the results of MRI scans to the data used in the Partin tables and in the pre-surgical Kattan nomogram (also known as the Memorial-Sloan Kettering Cancer Center or MSKCC nomogram) can improve the accuracy of these two commonly used prognostic methods. … READ MORE …

Biparametric vs. multiparametric MRI scanning in diagnosis of prostate cancer

We have recently started to see  a flurry of publications of papers suggesting that biparametric MRI (bpMRI) scans may be “better” — or at least more cost-effective — than multiparametric MRI (mpMRI) scans in the diagnosis of localized forms of prostate cancer. … READ MORE …

The role of mpMRI in monitoring of men on active surveillance

At least one paper has stated that some 40 percent of men diagnosed with low-risk prostate cancer here in the US are now being initially managed on active surveillance. If active surveillance is being done properly, this is a good thing! However, … READ MORE …

“The best” type of biopsy using mpMRI guidance to target the lesions

There have been suggestions that guided biopsies on the basis of multiparametric MRI (mpMRI) data are most accurate when done using so-called “in-bore” or “in-gantry” biopsies as opposed to mpMRI/TRUS fusion-guided biopsies. … READ MORE …

The evolving role of MRI imaging in undiagnosed prostate cancer

As we have been pointing out for a while, the actual and potential roles for the use of multiparametric MRI (mpMRI) scanning in the diagnosis of prostate cancer is changing, and quite fast too. … READ MORE …

The role of 3 T mpMRI in monitoring men on active surveillance

A newly published paper in the American Journal of Roetgenology provides an early data set on the application of 3 T multiparameric MRI scans in monitoring men on active surveillance (as opposed to the use of serial biopsies). … READ MORE …

PROMIS study endorses mpMRI prior to prostate biopsy for many patients

The PROMIS study is a UK-based study designed to confirm earlier data suggesting that having a multiparametric MRI (mpMRI) scan could really help to decide which men needed a prostate biopsy because they really did or didn’t have prostate cancer. … READ MORE …

mpMRIs, MRI/TRUS fusion-guided biopsies, and systematic biopsies in monitoring of men on active surveillance

A new article in the Journal of Urology has provided us with some initial insight into the value of multiparametric MRIs (mpMRIs) in monitoring progression of patients on active surveillance protocols. … READ MORE …

mpMRIs vs. biopsies for repeat evaluations on active surveillance

A question on the minds of many prostate cancer researchers and clinicians (not to mention their patients) is if and when we may be able to replace repeat systematic prostate biopsies for patients on active surveillance (or seeking to start on active surveillance) with the significantly less invasive multiparametric MRIs (mpMRIs). … READ MORE …

Targeted biopsy processes alone are not good enough for accurate diagnosis

A significant number of patients have wanted to believe that, with the coming of targeted biopsies based on multiparametric MRI imaging, the need for “random” systematic biopsies (e.g., standard 10- or 12-core biopsies) would go away. … READ MORE …

D’Amico on the individualization of prostate cancer risk management

In an interesting article in the September 2014 issue of The ASCO Post, Dr. Anthony D’Amico argues in favor of a future in which individualized approaches to risk will replace PSA screening alone as a means of determining who actually needs to be biopsied and (if necessary) receive treatment for clinically significant prostate cancer. … READ MORE …

MRI- and MRI/TRUS fusion-guided biopsy: an up-to-date review

The first issue of the new journal Urology Practice includes a very nice review of the use of MRI imaging in the evaluation, diagnosis, and biopsy of men with prostate cancer. … READ MORE …

Let’s compare the media hype to the actual data (about MR-guided biopsy)

According to an article online in The Australian today, “Men won’t need to have numerous painful needles in their rectum to find out if they have prostate cancer anymore”. … READ MORE …

What’s the best predictor of prostate cancer after a prior negative biopsy?

According to a recent prospective study from a group of Italian investigators, the answer to that question is, “Multiparametric magnetic resonance imaging” (mp-MRI). However, this needs to be confirmed in at least one other large, prospective study. … READ MORE …