Fig 1.
Selection of the 76 active surveillance patients.
Abbreviations: mpMRI = Multiparametric Magnetic Resonance Imaging; Bx = Prostate biopsy; PCa = Prostate cancer; PIRADS = Prostate Imaging Reporting And Data System 1.0; GS = Gleason score. PSAd = Prostate specific antigen density.
Table 1.
Demographics of the study cohort.
Table 2.
Comparison of two mpMRIs of 76 prostate cancer active surveillance patients.
Fig 2.
Serial mpMRI results of the 76 AS patients.
Abbreviations: mpMRI = Multiparametric Magnetic Resonance Imaging; PIRADS = Prostate Imaging And Data Reporting System 1.0; Bx = Biopsy; AS = Active surveillance.
Fig 3.
Characteristics of serial mpMRI changes in 14 patients with ≥3 mpMRIs.
Horizontal axis shows time from first mpMRI. Each ball refers to a single mpMRI. Color refers to PIRADS score. Number refers to number of suspicious lesions.
Table 3.
Serial mpMRI change (rise in tumour size, number or volume) and protocol-based treatment change.
Correlations.
Fig 4.
An example of tumour progression.
(A) Prostate MRI taken in September 2013. 71-year-old patient in AS. T2WI shows a small low signal intensity lesion (max diameter 9 mm). Restricted diffusion and focal enhancement was found in left midgland. Routine biopsies revealed Gleason score (GS) 3+3 prostate cancer in left apex and right base. (B) Same patient, prostate MRI taken in January 2015. The lesion appeared larger (max diameter 13 mm) in T2WI and more visible in diffusion and ADC map, while DCE remained unspecific. GS 4+5 prostate cancer was found in cognitively targeted biopsies. Radical prostatectomy in June 2015 proved GS 4+3 disease with two small foci in the right lobe as well. Also, 0.5 mm extraprostatic extension with 5 mm contact to external tissues was diagnosed. Tumour stage was pT3a.