[Hopespringpcsg] FW: [PPML] Study: MRI Missed 1 in 6 High-Grade Prostate Cancers

[Glen Tolhurst]

Hi all:
Discussion below wrt prostate MRI for PCa from a US blog.
Take care,
Glen

Multiple studies have now shown that when one does ONLY and MRI/TRUS fusion-guided biopsy of suspicious tissue, one can commonly "miss" some important areas of tumor in the prostate. 

The most appropriate way to biopsy any man today if they are either high-risk or if they are being considered as candidates for active surveillance is by giving them a combination biopsy involving both a standard, systematic, 12-core biopsy AND the MRI/TRUS fusion biopsy of tissue seen to be suspicious on an MRI.

While MRI scanning has definitively helped us to find cancerous tissue that was rarely, previoulsy, found on a standard 12-core TRUS-guided biopsy, the truth is that MRI scanning and evaluation of those MRI scans is not a "perfect" science when it comes to actually finding potentially dangerous areas of cancer in the prostate either.

The paper presented at the AUA (which I was at) is just one more confirmation of the same piece of knowledge.

Mike

On Fri, 22 May 2015 07:36:14 -0400, Vivian McGee <vfarah1 at NC.RR.COM> wrote:

>I'll read the linked article when I have more time, but from the 
>snippet, it sounds like "standalone" means without the biopsy. Why 
>though?  I always hear it as MRI-guided biopsy, not just MRI by itself. 
>Are they just trying to be provocative, even if misleading?  Well, 
>maybe actually READING the article will clarify. ;-)
>
>Vivian McGee
>
>Sent from my iPhone
>
>> On May 21, 2015, at 10:48 PM, John Vig <john.vig at GMAIL.COM> wrote:
>> 
>> http://www.medscape.com/viewarticle/845123?src=wnl_edit_tpal&uac=1012
>> 48PY
>> 
>> American Urological Association (AUA) 2105 Annual Meeting: Abstract 
>> MP60-11. Presented May 18, 2015.
>> 
>> "NEW ORLEANS — The much ballyhooed multiparametric (mp) MRI does not 
>> appear to be suited as stand-alone test for diagnosing prostate 
>> cancer after an elevated PSA, according to new research.
>> 
>> The expensive and powerful technology failed to identify 16% of men 
>> with high-grade cancer (Gleason score ≥7) in a prospective study of 
>> 1044 men with an elevated PSA.
>> 
>> Thus, men with an elevated PSA should consider a prostate biopsy even 
>> if an mpMRI appears normal, concluded the authors, led by Christopher 
>> Filson, MD, of UCLA.
>> ​.."​