Anwar Roshanali Padhani MD, Presenter: Advisory Board, Acuitas Medical Ltd Advisory Board, Siemens AG Speakers Bureau, Siemens AG Researcher, Siemens AG Speakers Bureau, Johnson & Johnson

Giuseppe Petralia MD, Abstract Co-Author: Nothing to Disclose

Heminder Kaur Sokhi MRCS, FRCR, Abstract Co-Author: Nothing to Disclose

Francesco Sanguedolce PhD, MD, Abstract Co-Author: Nothing to Disclose

Andrew Gogbashian MD, FRCR, Abstract Co-Author: Nothing to Disclose

Roberto Alonzi MD, Abstract Co-Author: Nothing to Disclose

Nicola Anyamene, Abstract Co-Author: Nothing to Disclose

Giles Hellawell MD, MRCS, Abstract Co-Author: Nothing to Disclose

• Multiparametric MRI (mpMRI) aids management of suspected/proven prostate cancer, but its clinical utility depends on the mpMRI approach, image quality & reporter expertise • mpMRI shows clinically significant disease (CSD), but will also miss cancer; thus interpretation should be aligned with clinical management priorities • Judicious use of mpMRI with clinical parameters reduces under treatment of significant disease & over-diagnosis/treatment of insignificant cancers  

• Overview individual mpMRI components (T2, diffusion, dynamic contrast enhancement, spectroscopy) with tumor biologic correlates & literature reviews of ability to detect CSD • Tumor detection using a disease prevalence approach & ability of mpMRI to rule in/out CSD • Demonstrate how prebiopsy mpMRI informs on biopsy technique choice improving precision of diagnosis • Show that surgical priorities & approaches are altered by risk group, index lesion locations & extracapsular disease • In low risk disease, show that mpMRI improves precision of patient selection at initial triage for active surveillance • In intermediate risk disease, show how mpMRI sub-groups enables patient selection for duration of androgen deprivation after radiotherapy • In high risk disease, imaging emphasis changes to local & nodal staging, tumor volume & metastatic disease assessments

http://abstract.rsna.org/uploads/2014/14011602/14011602_qq3b.pdf

Padhani, A, Petralia, G, Sokhi, H, Sanguedolce, F, Gogbashian, A, Alonzi, R, Anyamene, N, Hellawell, G, How Contemporary MRI Influences the Management of Prostate Cancer Patients.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14011602.html