06.05.2023 | Commentary
How should we prepare a generation of radiologists for MRI-based prostate cancer screening?
verfasst von:
Philippe Puech, Patricia Andrea Gutierrez, Vibeke Berg-Løgager, Geert Villeirs
Erschienen in:
European Radiology
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Ausgabe 10/2023
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Excerpt
In 2012, the European Society of Urogenital Radiology (ESUR) released a foundational paper on how to perform, interpret, and report prostate MRI, with the introduction of Prostate Imagining Reporting and Data System (PI-RADS) [
1]. This was a significant step forward in the quality assurance and standardisation of practices, and provided a stable reference for training radiologists [
2]. Since then, the use of prostate MRI in prostate cancer (PCa) management has continued to expand, encompassing early diagnosis, active surveillance, focal therapy, and recurrence detection. Prostate MRI became widely adopted by the urology community and in 2019 it was endorsed by the European Association of Urology, prior to initial prostate biopsy [
3]. The current impact of MRI on patient management is such that urologists, oncologists, and radiation therapists can no longer do without it, and start to consider its potential for PCa screening [
4,
5]. In 2022, the European Commission issued a resolution, recommending stepwise but extended screening policies for various cancers, including PCa, which explicitly integrates MRI [
6]. At the same time, Hugosson et al showed that including MR data in the algorithm of PCa screening in a large prospective population can reduce the risk of overdiagnosis by half, at the cost of delaying detection of intermediate-risk tumours in a small proportion of patients [
5]. These elements point out that prostate MRI may soon become decisive for PCa screening, and reinforce the importance of qualification, certification, and accreditation of radiologists or imaging centres performing prostate MRI [
7]. …