Robert E. Reiter, MD, presented “MRI: Can It Be Used to Plan Ablative Therapies?” during the 31st International Prostate Cancer Update in July 2021 in Snowbird, Utah.
How to cite: Reiter, Robert E. “MRI: Can It Be Used to Plan Ablative Therapies?” July 2021. Accessed Apr 2024. https://grandroundsinurology.com/mri-can-it-be-used-to-plan-ablative-therapies/
MRI: Can It Be Used to Plan Ablative Therapies? – Summary
Robert E. Reiter, MD, the Bing Professor of Urology and Molecular Biology and Director of the Prostate Cancer Treatment and Research Program at the David Geffen School of Medicine at the University of California, Los Angeles, discusses and evaluates MRI in terms of its ability to select patients for and help plan ablative therapies. He begins with an evaluation of MRI’s capabilities in patient selection. Dr. Reiter cites a study on multiparametric (mp)MRI detection of prostate cancer (PCa) foci that found mpMRI was capable of missing 20-30% of significant tumors. He also discusses a study of systematic and targeted biopsies concordance, finding that there was non-concordance in 36.1% of cases. Dr. Reiter cites a third study that found that 48% of MRI-selected candidates for hemiablation were actually ineligible for prostatectomy. He continues with a discussion of using MRI for targeting PCa adequately for complete ablation. Dr. Reiter reviews a study on mpMRI and predicting pathological tumor size, finding that MRI was less useful for smaller lesions but was quite effective for larger and higher-grade tumors. He suggests that MRI is not particularly useful for predicting tumor distance from the urethra based on one study that suggests that finding tumors near the urethra is important due to about 66% of PCa tumors being within 5 mm of the urethra, and another study finding that MRI fails to detect many tumors near the urethra based on an AUC curve. Dr. Reiter concludes that MRI can aid patient selection and planning but has multiple shortcomings that need to be accounted for.
About The 31st Annual International Prostate Cancer Update:
The International Prostate Cancer Update (IPCU), founded in 1990, is a multi-day CME conference focused on prostate cancer treatment updates with expert, international faculty. It is led by expert physicians and is designed for urologists, medical oncologists, radiation oncologists, and other healthcare professionals involved in the diagnosis and treatment of prostate cancer. Dr. Reiter delivered this educational activity during the 31st iteration of the meeting in July 2021 in Snowbird, Utah.
