Standardized MRI and Molecular Imaging Reporting for Focal Therapy Follow-up

How to cite: Margolis, D. “Standardized MRI and Molecular Imaging Reporting for Focal Therapy Follow-up.” Grand Rounds in Urology. September 15, 2025. Accessed Oct 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.

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