Prostate Magnetic Resonance Imaging for Local Recurrence Reporting (PI-RR): International Consensus -based Guidelines on Multiparametric Magnetic Resonance Imaging for Prostate Cancer Recurrence after Radiation Therapy and Radical Prostatectomy

Valeria Panebianco; Geert Villeirs; Jeffrey C Weinreb; Baris I Turkbey; Daniel J Margolis; Jonathan Richenberg; Ivo G Schoots; Caroline M Moore; Jurgen Futterer; Katarzyna J Macura; Aytekin Oto; Leonardo K Bittencourt; Masoom A Haider; Georg Salomon; Clare M Tempany; Anwar R Padhani; Jelle O Barentsz

doi:10.1016/j.euo.2021.01.003

Prostate Magnetic Resonance Imaging for Local Recurrence Reporting (PI-RR): International Consensus -based Guidelines on Multiparametric Magnetic Resonance Imaging for Prostate Cancer Recurrence after Radiation Therapy and Radical Prostatectomy

Eur Urol Oncol. 2021 Dec;4(6):868-876. doi: 10.1016/j.euo.2021.01.003. Epub 2021 Feb 10.

Authors

Valeria Panebianco¹, Geert Villeirs², Jeffrey C Weinreb³, Baris I Turkbey⁴, Daniel J Margolis⁵, Jonathan Richenberg⁶, Ivo G Schoots⁷, Caroline M Moore⁸, Jurgen Futterer⁹, Katarzyna J Macura¹⁰, Aytekin Oto¹¹, Leonardo K Bittencourt¹², Masoom A Haider¹³, Georg Salomon¹⁴, Clare M Tempany¹⁵, Anwar R Padhani¹⁶, Jelle O Barentsz⁹

Affiliations

¹ Department of Radiological Sciences, Oncology and Pathology, Sapienza University/Policlinico Umberto I, Rome, Italy. Electronic address: valeria.panebianco@uniroma1.it.
² Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium.
³ Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA.
⁴ National Cancer Institute, Center for Cancer Research, Bethesda, MD, USA.
⁵ Weill Cornell Imaging, Cornell University, New York, NY, USA.
⁶ Department of Imaging, Brighton and Sussex University Hospitals NHS Trust and Brighton and Sussex Medical School, Brighton, UK.
⁷ Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
⁸ Department of Urology, University College London, London, UK.
⁹ Department of Radiology and Nuclear Medicine, Radboudumc, Nijmegen, The Netherlands.
¹⁰ Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
¹¹ Department of Radiology, University of Chicago, Chicago, IL, USA.
¹² Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio.
¹³ Department of Medical Imaging, University of Toronto, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada.
¹⁴ Martini-Clinic Prostate Cancer Center, University Hospital Hamburg-Eppendorf, Hamburg, Germany.
¹⁵ Department of Radiology, Brigham &Women's Hospital, Boston, MA, USA.
¹⁶ Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, UK.

PMID: 33582104
DOI: 10.1016/j.euo.2021.01.003

Abstract

Background: Imaging techniques are used to identify local recurrence of prostate cancer (PCa) for salvage therapy and to exclude metastases that should be addressed with systemic therapy. For magnetic resonance imaging (MRI), a reduction in the variability of acquisition, interpretation, and reporting is required to detect local PCa recurrence in men with biochemical relapse after local treatment with curative intent.

Objective: To propose a standardised method for image acquisition and assessment of PCa local recurrence using MRI after radiation therapy (RP) and radical prostatectomy (RT).

Evidence acquisition: Prostate Imaging for Recurrence Reporting (PI-RR) was formulated using the existing literature. An international panel of experts conducted a nonsystematic review of the literature. The PI-RR system was created via consensus through a combination of face-to-face and online discussions.

Evidence synthesis: Similar to with PI-RADS, based on the best available evidence and expert opinion, the minimum acceptable MRI parameters for detection of recurrence after radiation therapy and radical prostatectomy are set. Also, a simplified and standardised terminology and content of the reports that use five assessment categories to summarise the suspicion of local recurrence (PI-RR) are designed. PI-RR scores of 1 and 2 are assigned to lesions with a very low and low likelihood of recurrence, respectively. PI-RR 3 is assigned if the presence of recurrence is uncertain. PI-RR 4 and 5 are assigned for a high and very high likelihood of recurrence, respectively. PI-RR is intended to be used in routine clinical practice and to facilitate data collection and outcome monitoring for research.

Conclusions: This paper provides a structured reporting system (PI-RR) for MRI evaluation of local recurrence of PCa after RT and RP.

Patient summary: A new method called PI-RR was developed to promote standardisation and reduce variations in the acquisition, interpretation, and reporting of magnetic resonance imaging for evaluating local recurrence of prostate cancer and guiding therapy.

Keywords: Magnetic resonance imaging; Prostate Magnetic Resonance Imaging for Recurrence Reporting (PI-RR); Prostate cancer recurrence.

Publication types

Review

MeSH terms

Consensus
Humans
Magnetic Resonance Imaging
Male
Multiparametric Magnetic Resonance Imaging*
Neoplasm Recurrence, Local / diagnostic imaging
Prostate
Prostate-Specific Antigen
Prostatectomy
Prostatic Neoplasms* / diagnostic imaging
Prostatic Neoplasms* / radiotherapy
Prostatic Neoplasms* / surgery

Substances

Prostate-Specific Antigen