Multiparametric MRI in prostate cancer

M. de Rooij

PhD thesis, 2017

Abstract

Prostate cancer (PCa) is the most common malignancy among men in developed countries, and has a large societal burden. Approximately 50-70% of the detected PCa is a low-risk type that will never cause symptoms during a life time. However, in the other 30-50% of the men, an intemediate- or high-risk type is diagnosed, which needs to be treated. The challenge is to identify the aggresive tumours early and to treat these accordingly, while leaving alone low-risk PCa. Systemic transrectal ultrasound guided biopsy (TRUS-GB) is the current standard of care after an elevated serum prostate specific antigen (PSA). It is an invasive procedure, and it is known that important PCa is being missed or misclassified with this method, whereas low-risk PCa which does not require treament, may be found. This leads to over-dagnosis and over-treatment of low-risk tumours, and under treatment of intermediate- or high risk PCa. Multiparametric magnetic resonance imaging (mp-MRI), preferably usd as an advanced imaging technique before biopsy, shows promising results in improving PCa diagnosis.

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