Magnetic resonance imaging for prostate cancer before radical and salvage radiotherapy: What radiation oncologists need to know

Table 1 European Society of Urogenital Radiology scoring of extracapsular extension in prostate cancer

Findings	Score
Abutment	1
Irregularity	3
Neurovascular bundle thickening	4
Bulge, loss of capsule	4
Measurable extra-capsular disease	5

Table 2 Studies evaluating the impact of the staging using magnetic resonance imaging in prostate cancer patients treated with radiotherapy

Ref.	Year	Type of MRI	No. of patients	Field strength	Coil	Tumor stage shift (%)	Risk group changes (%)	Change in RT (CTV, doses, HT) (%)	Technique validation
Jackson et al[75]	2005	Morphological	199	1.5T	PAB	55	NR	32.62	No
Couñago et al[76]	2014	Multiparametric	103	3T	PAB	94.1	33.9	33.9	Yes
Chang et al[77]	2014	Morphological	115	1.5T	PAB	68.6	7	201	No
Panje et al[8]	2015	multiparametric	122	1.5T and 3T	PAB	55.7	28.7	30	No
Horsley et al[78]	2015	Morphological	509	1.5T	PAB	20	9	18	No
Yamaguchi et al[79]	2015	Morphological	157	1.5T	PAB	25	9	81	No
Couñago et al[6]	2015	Multiparametric	274	3T	PAB	90.4	32.8	43.8 or 52.53	Yes
Pullini et al[28]	2016	Multiparametric	44	3T	PAB	65.9	40.9	NR	No
Liauw et al[27]	2016	Multiparametric	122	3T	PAB	NR	18	22	No

¹Exclusive assessment of the CTV change;

²Data from T1-T2 to T3-T4 upstaging;

³Values according to the HT criteria in intermediate-risk patients. PAB: Phased-array-bodycoil; NR: Not reported; CTV: Clinical target volume; HT: Hormonal therapy.

Table 3 Studies on multiparametric magnetic resonance imaging with low prostate-specific antigen levels for the diagnosis of local recurrence after radical prostatectomy

Ref.	Year	Desing	Coil and Magnet	No. of patients	PSA (mean or median)	Mean or median lesion size	Reference standard	% rRL	MRI sequences, Se, Spe, PPV, NPV, Acc
Linder et al[38]	2007	Retrospective	PAC + ERC 1.5T and 3T	187	0.59 ng/mL	10 mm	TRUS biopsy, PSA reduction after SRT or increased lesion size on serial imaging	91	T2 + DCE Se: 91% Spe: 45% PPV: 85% NPV: 60%
Rischke et al[39]	2012	Retrospective	PAC 1.5T	33	0.30 ng/mL	11 mm	PSA reduction after SRT and changes in MRI after SRT	67	T2 + DCE Se: 67% Spe: 100% PPV: 100% NPV: 83% Acc: 83%
Liauw et al[37]	2013	Retrospective	ERC 1.5T and 3T	88	0.30 ng/mL	0.26 cc	None	24	T2 + DCE + DWI
Park et al[56]	2014	Retrospective	PAC 1.5T and 3T	113	0.43 ng/mL	12 mm	TRUS biopsy	NR	T2 + DCE
Verma et al[42]	2014	Retrospective	PAC 3T	90	0.20 ng/mL negative MRI 0.40 ng/mL positive MRI	NR	None	22.2	T2 + DCE + DWI
Couñago et al[40]	2015	Retrospective	PAC 3T	57	0.40 ng/mL	15.2 mm	None	24.6	T2 + DCE + DWI
Hernandez et al[41]	2015	Retrospective	PAC 3T	70	0.38 ng/mL	8.5 mm	None	47 (local + lymph nodes) 38.6 (local)	T2 + DCE + DWI

mpMRI: Multiparametric MRI; RP: Radical prostatectomy; rRL: Radiographic local recurrence; T2: T2-weighted imaging; DCE: Dynamic contrast-enhanced imaging; DWI: Diffusion-weighted imaging; Se: Sensitivity; Spe: Specificity; PPV: Positive predictive value; NPV: Negative predictive value; Acc: Accuracy; PAC: Phased-array coil; ERC: Endorectal coil; NR: Not reported, SRT: Salvage radiation therapy.