The Role of Imaging in Suspected Prostate Cancer

• Published in: European oncology & haematology 2011, Vol.7 (4), p.247
• Main Authors: Ouzzane, Adil, Villers, Arnauld
• Format: Article
• Language: English
• ISSN: 2045-5275
• DOI: 10.17925/EOH.2011.07.04.247

Among a multitude of tests available to evaluate patients with suspected prostate cancer, modern imaging techniques seem to be the most relevant and their use is growing fast. Magnetic resonance imaging (MRI) technology is the most important imaging tool for identifying early prostate cancers, characterising tumours, helping in patient risk stratification and enabling focused use of biopsy. In addition, recent advances in transrectal ultrasonography of the prostate, such as realtime tissue elastography and contrast-enhanced ultrasonography, allow better identification of cancer. The optimal prostate cancer diagnostic strategy has to be validated. However, one way of improving identification in patients referred for screening might be pre-biopsy MRI, which would provide guidance for targeting biopsies. A ‘targeted biopsies only’ strategy (that is, without systematic biopsies) may reduce the number of biopsies (indicated only in patients with positive imaging), therefore avoiding the potentially unnecessary diagnosis of insignificant cancer. Any prospective, randomised trial testing MRI as an adjunct or replacement for biopsies will need to be carefully designed to include cost–utility and cost-effectiveness analysis of imaging.