ArticleCanadian Urological Association journal = Journal de l'Association des urologues du Canada2022
Serial prostate magnetic resonance imaging fails to predict pathological progression in patients on active surveillance.
Article in Canadian Urological Association journal = Journal de l'Association des urologues du Canada, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed, 1 citations in OpenAlex.
- Automatic Characterization of Prostate Suspect Lesions on T2-Weighted Image Acquisitions Using Texture Features and Machine-Learning Methods: A Pilot Study.Diagnostics (Basel, Switzerland) · 2025Article
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionLimited data guide urological practice when employing prostate magnetic resonance imaging (MRI) in active surveillance (AS) protocols. To determine the ability of prostate MRI to predict pathological progression in AS patients, we correlated findings of serial MRI with results of surveillance biopsies.
methodsPatients on AS with ≥2 prostate MRI and ≥2 prostate biopsies were included. Prostate Imaging-Reporting and Data System (PI-RADS) score upgrade, as assigned by experienced radiologists, was used to assess the ability of imaging to predict pathological biopsy progression. Imaging test statistics and the odds ratio of pathological progression according to MRI upgrade were calculated.
resultsOf 121 patients meeting criteria, 36 (30%) demonstrated MRI upgrade. Biopsy progression was noted in 55 patients (46%). Of these, 20 patients (37%) had biopsy progression predicted by MRI upgrade, while the remaining (n=35) had no lesion upgrade on prostate MRI. Conversely, among those with no biopsy progression (n=66), 16 patients (24%) had a false-positive upgrade on serial MRI. We report a sensitivity and specificity of MRI change for pathological progression of 36% and 76%, respectively. Although MRI change was associated with a positive predictive value of 56% for pathological progression, patients with a high-suspicion lesion (PI-RADS >3) at any time were more likely to experience disease progression, (odds ratio 3.3, 95% confidence interval 1.6-8.0, p<0.01).
conclusionsGiven its modest sensitivity/specificity, serial prostate MRI should be used judiciously as a surveillance tool. However, when prostate MRI demonstrates a PI-RADS >3 lesion, a high index of suspicion should be maintained, as these patients are more likely to progress on AS.
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Registered trials
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