Eur Radiol: What signs on MRI indicate tumor progression for low-risk prostate cancer?

Some prostate cancer lesions in the progression of low risk, direct surgery is a bit worthless, do not do surgery and a little uneasy! So how good should we take prostate cancer like this? Active Testing (AS) is the recommended guideline for patients with low-risk prostate cancer.
the purpose of ass is to reduce overtreated while identifying tumor progress, the degree of progress can be controlled in the healing time window.
multi-parameter magnetic resonance imaging (mpMRI) examination is now an integral part of the AS scenario.
, follow-up observation is mainly based on clinical synthesis information such as combined prostate-specific antigens (PSA), digital rectal examination and re-phased biopsy.
the invasive biopsy method in this program makes some patients look down on AS, and MRI scanning has a certain substitute effect on the invasive evaluation method because of its non-invasiveness.
, mpMRI's role in AS follow-up scenarios is becoming increasingly important.
, however, the consistency of the signs of progress in evaluating imaging was uneven.
, there is a growing clamour to find a reliable mpMRI evaluation.
recently, a paper published on Eur Radiol called MRI-derived PRECISE scores for predictive pathological-confirmed radiological progression in prostate patients on active surveillance systems identifies the predicted value of progression and its relevance to pathological progression by establishing a change (PRECISE) system in the series assessment of prostate cancer (PCa) patients receiving active monitoring (AS).
study included 295 PCa patients who participated in the AS study between 2011 and 2018.
baseline multi-parameter magnetic resonance imaging (mpMRI) at the beginning of the AS for biopsy.
two urologists with 10 and 13 years of experience, respectively, made a forward-looking assessment of the follow-up mpMRI study.
the patient PRECISE score was divided into two groups at the critical value of the optimal truncation value of 4, and its sensitivity, specificity, positive prediction and negative prediction were calculated.
the ROC curve based on the combined MRI-US guided biopsy results, and the diagnostic performance is evaluated by using the area under the ROC curve.
clinical and mpMRI parameters were associated with AS disease progression when using Cox regression for single-variable analysis to assess baselines.
. PRECISE score 1.
62-year-old male patient with PSA of 4.53 ng/ml.
. PRECISE Score 2.
72-year-old male patient with PSA of 3.4 ng/ml.
. PRECISE Score 4.
66-year-old male patient with PSA of 3.09 ng/ml.
. PRECISE score 5.
68-year-old male patient with PSA of 5.1 ng/ml.
. THE PRECISE scoring system showed a progress rate of 13.9% (41/295) in a 52-month mid-52-month follow-up to assess the value of prostate cancer patients in AS.
critical value ≥4, the Precise scoring system shows sensitivity, specificity, PPV and NPV of 0.76, 0.89, 0.52 and 0.96, respectively.
AAUC is 0.82 (95% CI - 0.74-0.90).
only prostate-specific antigen density (PSA-D), Licht lesions score, and lesions size are baseline predictive indicators of tumor progression (average p .lt;0.05).
PRECISE scoring system has good diagnostic efficacy in assessing the progression of prostate cancer tumors, and its high NPV may help reduce the number of follow-up biopsies required in AS patients.