MRI should be routine for all patients with localized prostate cancer? | Opinion: Yes

Vol. 42 (6): 1062-1064, November – December, 2016

doi: 10.1590/S1677-5538.IBJU.2016.06.03


DIFFERENCE OPINION

Ronaldo Hueb Baroni 1

1 Hospital Israelita Albert Einstein, SP, Brasil


Keywords: Magnetic Resonance Imaging; Prostatic Neoplasms; Diagnosis; Watchful Waiting


Magnetic resonance imaging (MRI) has been used for staging prostate cancer (PCa) since the 1990’s, more precisely after the advent of the endorectal coil, which enabled significant improvement in the quality of the examination. Also, the standardization of prostate MRI with multiparametric sequences (including high resolution T2-weighted, diffusion and dynamic contrast-enhanced or perfusion images), together with the progressive learning curve by uro-radiologists, contributed to include the method definitively in the list of available procedures for staging prostate cancer (1).

The accuracy of multiparametric MRI (mpMRI) is greater than that of other isolated clinical, laboratory and imaging methods available, with specificities around 85% for detection of extracapsular extension and seminal vesicle invasion (2). Moreover, the incremental value of MRI has been validated around a decade ago in three articles by the interdisciplinary group of Memorial Sloan Kettering Cancer Center, demonstrating that the addition of MRI to the commonly used clinical nomograms significantly increases the accuracy for prediction of organ-confined disease, extracapsular extension and seminal vesicle invasion (3-5).

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