Modern Approach in Radiological Diagnosis of Prostate Cancer (Systematic Review of International Clinical Guidelines and Clinical Studies Over 2014–2020)

An increase in the level of prostate-specific antigen requires additional examination of the patient in order not to subject him to unnecessary treatment in case of clinically insignificant prostate cancer and, conversely, to carry out the necessary volume of measures in case of clinically significant prostate cancer. The paper presents the modern solutions for effective usage of diagnostic methods in visualization of clinically significant prostate cancer. To assess the advantages and disadvantages of various methods for diagnosing prostate cancer a search of publications for 2014–2020 period was conducted based on the Scopus, Web of Science, PubMed databases. The request included keywords: prostate cancer, multiparametric MRI, multiparametric ultrasound, PSMA PET/CT. We selected 27 articles. The review includes guidelines from the European Association of Urology, the American Urological Society, the American College of Radiology, and one practice recommendation.

multiparametric magnetic resonance imaging, prostate cancer, prostate biopsy, active surveillance

1. Ilic D, Djulbegovic M, Jung JH, Hwang EC, Zhou Q, Cleves A, et al. Prostate cancer screening with prostate-specific antigen (PSA) test: a systematic review and meta-analysis. BMJ. 2018; 362: k3519. doi: 10.1136/bmj.k3519

2. Chung DY, Kim MS, Lee JS, Goh HJ, Koh DH, Jang WS, et al. Clinical significance of multiparametric magnetic resonance imaging as a preoperative predictor of oncologic outcome in very low-risk prostate cancer. J Clin Med. 2019; 8(4): 542. doi: 10.3390/jcm8040542

3. Mottet N, Cornford P, van den Bergh RCN, Briers E, De Santis M, Fanti S, et al. Prostate cancer: EAU Guideline. Available at: https://uroweb.org/guideline/prostate-cancer/ (accessed October 28, 2020).

4. Sanda MG, Chen RC, Crispino T, Freedland S, Greene K, Klotz LH, et al. Clinically localized prostate cancer: AUA/ASTRO/SUO Guideline; 2017. Available at: https://www.auanet.org/guidelines/prostate-cancer-clinically-localized-guideline (accessed October 28, 2020).

5. Barr RG, Cosgrove D, Brock M, Cantisani V, Correas JM, Postema AW, et al. WFUMB Guidelines and Recommendations on the clinical use of ultrasound elastography: part 5. Prostate. Ultrasound Med Biol. 2017; 43(1): 27–48. doi: 10.1016/j.ultrasmedbio.2016.06.020

6. Mannaerts CK, Wildeboer RR, Postema AW, Hagemann J, Budäus L, Tilki D, et al. Multiparametric ultrasound: evaluation of greyscale, shear wave elastography and contrast-enhanced ultrasound for prostate cancer detection and localization in correlation to radical prostatectomy specimens. BMC Urol. 2018; 18(1): 98. doi: 10.1186/s12894-018-0409-5

7. Kamoi K., Okihara K., Ochiai A., Ukimura O., Mizutani Y., Kawauchi A. The utility of transrectal real-time elastography in the diagnosis of prostate cancer. Ultrasound Med Biol. 2008; 34(7): P1025–32. doi: 10.1016/j.ultrasmedbio.2007.12.002

8. Mannaerts CK, Wildeboer RR, Remmers S, Kollenburg RA, Kajtazovic A, Hagemann J, et al. Multiparametric ultrasound for prostate cancer detection and localization: correlation of B-mode, shear wave elastography and contrast enhanced ultrasound with radical prostatectomy specimens. J Urol. 2019; 202(6): 1166–73. doi: 10.1097/JU.0000000000000415

9. Chatfield M, Hicks L, Kaur D, Vivian-Davis C. ACR PI-RADS: prostate imaging and reporting and data system. Version 2.1. Reston, VA, American College of Radiology; 2019. Available at: https://www.acr.org/Clinical-Resources/Reporting-and-DataSystems/PI-RADS (accessed October 28, 2020).

10. Ahmed HU, Bosaily AE, Brown LC, Gabe R, Kaplan R, Parmar M, et al. Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study. Lancet. 2017; 389(10071): 815–22. doi: 10.1016/S0140–6736(16)32401–1

11. Mehralivand S, Shih JH, Harmon S, Clayton Smith C, Bloom J, Czarniecki M, et al. A grading system for the assessment of risk of extraprostatic extension of prostate cancer at multiparametric MRI. Radiology. 2019; 290(3): 709–19. doi: 10.1148/radiol.2018181278

12. Tosoian JJ, Loeb S, Epstein JI, Turkbey B, Choyke P, Schaeffer EM. Active surveillance of prostate cancer: use, outcomes, imaging, and diagnostic tools. Am Soc Clin Oncol Educ Book. 2016; 35: e235–45. doi: 10.14694/EDBK_159244

13. Gordon LG, James R, Tuffaha HW, Lowe A, Yaxley J. Cost-effectiveness analysis of multiparametric MRI with increased active surveillance for low-risk prostate cancer in Australia. J Magn Reson Imaging. 2017; 45(5): 1304–15. doi: 10.1002/jmri.25504

14. Vos LJ, Janoski M, Wachowicz K, Yahya A, Boychak O, Amanie J, et al. Role of serial multiparametric magnetic resonance imaging in prostate cancer active surveillance. World J Radiol. 2016; 8(4): 410–8. doi: 10.4329/wjr.v8.i4.410

15. Calais J, Ceci F, Eiber M, Hope T, Hofman M, Rischpler C, et al. 18F-fluciclovine PET-CT and 68Ga-PSMA-11 PET-CT in patients with early biochemical recurrence after prostatectomy: a prospective, single-centre, single-arm, comparative imaging trial. Lancet Oncol. 2019; 20(9): 1286–94. doi: 10.1016/S14702045(19)30415-2

16. Eissa A, Elsherbiny A, Coelho R, Rassweiler J, Davis JW, Porpiglia F, et al. The role of 68Ga-PSMA PET/CT scan in biochemical recurrence after primary treatment for prostate cancer: a systematic review of the literature. Minerva Urol Nefrol. 2018; 70(5): 462–78. doi: 10.23736/S0393-2249.18.03081-3

17. Hara T, Ogata T, Wada H, Yabukia T, Kanazawa S. Prostate cancer detection with multiparametric MRI: a comparison of 1 M-concentration Gadobutrol with 0.5 M-concentration gadolinium-based contrast agents. Curr. Urol. 2017; 11(4): 201–5. doi: 10.1159/000447219

18. Kossov FA, Bulychkin PV, Olimov BP, Panov VO, Tkachev SI, Buydenok YuV, et al. Possibilities of multiparametric magnetic resonance imaging in the personalization of salvage radiation therapy in patients with prostate cancer recurrence. Journal of Radiology and Nuclear Medicine. 2018; 99(2): 91–100 (in Russian). doi: 10.20862/0042-4676-2018-99-2-91-100

19. ACR Manual on Contrast Media. 2020. Available at: https://www.acr.org/-/media/ACR/Files/Clinical-Resources/Contrast_Media.pdf (accessed December 23, 2020).

20. ESUR Guidelines on Contrast Agents 10.0. 2018. Available at: http://www.esur.org/fileadmin/content/2019/ESUR_Guidelines_10.0_Final_Version.pdf (accessed December 23, 2020).

21. D’Amico AV, Whittington R, Malkowicz SB, Schultz D, Blank K, Broderick GA, et al. Biochemical outcome after radical prostatectomy, external beam radiation therapy, or interstitial radiation therapy for clinically localized prostate cancer. JAMA. 1998; 280(11): 969–74. doi: 10.1001/jama.280.11.969

22. Epstein JI, Zelefsky MJ, Sjoberg DD, Nelson JB, Egevad L, MagiGaluzzi C, et al. A contemporary prostate cancer grading system: a validated alternative to the Gleason score. Eur Urol. 2016; 69(3): 428–35. doi: 10.1016/j.eururo.2015.06.046

23. Klotz LH. Active surveillance with selective delayed intervention: walking the line between overtreatment for indolent disease and undertreatment for aggressive disease. Can J Urol. 2005; 12(Suppl 1): 53–7.

24. Gaur S, Turkbey B. Prostate MRI for post-treatment evaluation and recurrence. Radiol Clin North Am. 2018; 56(2): 263–75. doi: 10.1016/j.rcl.2017.10.008

25. Shaish H, Kang SK, Rosenkrantz AB. The utility of quantitative ADC values for differentiating high-risk from low-risk prostate cancer: a systematic review and meta-analysis. Abdom Radiol (NY). 2017; 42(1): 260–70. doi: 10.1007/s00261-016-0848-y

26. Alberts AR, Roobol MJ, Drost FJH, Leenders GJ, Bokhorst LP, Bangma CH, et al. Risk-stratification based on magnetic resonance imaging and prostate-specific antigen density may reduce unnecessary follow-up biopsy procedures in men on active surveillance for low-risk prostate cancer. BJU Int. 2017; 120(4): 511–9. doi: 10.1111/bju.13836

27. Kim JY, Kim SH, Kim YH, Lee HJ, Kim MJ, Choi MS. Low-risk prostate cancer: the accuracy of multiparametric MR imaging for detection. Radiology. 2014; 271(2): 435–44. doi: 10.1148/radiol.13130801

28. Kim TH, Kim CK, Park BK, Jeon HG, Jeong BC, Seo SI, et al. Relationship between Gleason score and apparent diffusion coefficients of diffusion-weighted magnetic resonance imaging in prostate cancer patients. Can Urol Assoc J. 2016; 10(11–12): 377–82. doi: 10.5489/cuaj.3896

29. Guo R, Cai L, Fan Y, Jin J, Zhou L, Zhang K. Magnetic resonance imaging on disease reclassification among active surveillance candidates with low-risk prostate cancer: a diagnostic metaanalysis. Prostate Cancer Prostatic Dis. 2015; 18(3): 221–8. doi: 10.1038/pcan.2015.20

30. Wegelin O, van Melick HH, Hooft L, Bosch JL, Reitsma HB, Barentsz JO, et al. Comparing three different techniques for magnetic resonance imaging-targeted prostate biopsies: a systematic review of in-bore versus magnetic resonance imaging-transrectal ultrasound fusion versus cognitive registration. Is there a preferred technique? Eur Urol. 2017; 71(4): 517–31. doi: 10.1016/j.eururo.2016.07.041

31. Dubitskiy DL, Mishchenko AV, Trofimenko IA. Magnetic resonance imaging of the prostate gland. 2nd ed. Мoscow: GEOTARMedia; 2021 (in Russian).