How to cite: Margolis, D. “Standardized MRI and Molecular Imaging Reporting for Focal Therapy Follow-up.” Grand Rounds in Urology. September 15, 2025. Accessed Mar 2026. https://grandroundsinurology.com/standardized-mri-and-molecular-imaging-reporting-for-focal-therapy-follow-up/
Summary
Daniel Margolis, MD, Associate Professor of Radiology, Weill Cornell Medical College, New York, New York, shares goals for a standardized framework that aligns molecular imaging and anatomic imaging with clinical endpoints. He emphasized that standardized elements should define when to suspect residual or recurrent clinically significant disease and when to trigger targeted or systematic biopsy. He notes that consistent terminology and scoring may reduce variation in interpretation between centers.
Dr. Margolis outlines key reporting domains for follow-up. These include baseline characterization before treatment, post-procedure time points, definitions of index lesion and ablation zone, and specific findings that increase suspicion of residual disease. He highlights that structured reporting should capture lesion location, extent relative to the ablation zone, and concordance with biopsy.
Dr. Margolis discusses the role of molecular imaging. He indicates that prostate-specific membrane antigen (PSMA) imaging may identify lesions that are occult on conventional imaging and that careful standardization is needed to avoid inconsistent results. He also summarizes considerations for integrating targeted biopsy when imaging raises suspicion.
Dr. Margolis argues that consensus-driven standardized reporting can enhance clinical care, enable comparable outcomes across studies, and support future trials that evaluate short-term and intermediate outcomes after focal therapy.
The Global Summit on Precision Diagnosis and Treatment of Prostate Cancer is a unique multi-disciplinary forum organized to inform the key health care stakeholders about the emerging advances in clinical case and research and create a consensus-based vision for the future of precision care and educational and research strategy for its realization. The mission of the Summit is to fill the currently existing gap between the key experts of in vivo imaging, the world authorities in the in vitro fluid- and tissue-based molecular diagnostics, including genomics, and thought leaders in the development of novel observation strategies (e.g., active surveillance, or AS) and therapeutic interventions.
ABOUT THE AUTHOR
Daniel Margolis, MD, is an Associate Professor of Radiology at Weill Cornell Medicine in New York City. He is a graduate of the University of California, Berkeley, and earned his MD from the University of Southern California in Los Angeles. After a transitional year-long internship with the Los Angeles VA Healthcare System, he completed a residency in Diagnostic Radiology at the University of California, Los Angeles. Dr. Margolis completed a Fellowship in Advanced Imaging at Stanford University Medical Center and the K30 Graduate Training Program in Translational Investigation at UCLA. He has 90+ publications regarding using MRI for detecting and characterizing prostate cancer. He serves on the American College of Radiology Prostate Imaging Reporting and Data Systems Committee and is Co-Chair of the Society of Abdominal Radiology Prostate Cancer Disease-Focused Panel.
