The Transatlantic Recommendations for Prostate Gland Evaluation with Magnetic Resonance Imaging After Focal Therapy (TARGET): A Systematic Review and International Consensus Recommendations.

Ablation Consensus Cryotherapy Focal therapy High-intensity focused ultrasound In-field recurrence Magnetic resonance imaging Multiparametric Prostate cancer Recurrence

Journal

European urology
ISSN: 1873-7560
Titre abrégé: Eur Urol
Pays: Switzerland
ID NLM: 7512719

Informations de publication

Date de publication:
21 Mar 2024
Historique:
received: 03 05 2023
revised: 29 11 2023
accepted: 04 02 2024
medline: 23 3 2024
pubmed: 23 3 2024
entrez: 22 3 2024
Statut: aheadofprint

Résumé

Magnetic resonance imaging (MRI) can detect recurrences after focal therapy for prostate cancer but there is no robust guidance regarding its use. Our objective was to produce consensus recommendations on MRI acquisition, interpretation, and reporting after focal therapy. A systematic review was performed in July 2022 to develop consensus statements. A two-round consensus exercise was then performed, with a consensus meeting in January 2023, during which 329 statements were scored by 23 panellists from Europe and North America spanning urology, radiology, and pathology with experience across eight focal therapy modalities. Using RAND Corporation/University of California-Los Angeles methodology, the Transatlantic Recommendations for Prostate Gland Evaluation with MRI after Focal Therapy (TARGET) were based on consensus for statements scored with agreement or disagreement. In total, 73 studies were included in the review. All 20 studies (100%) reporting suspicious imaging features cited focal contrast enhancement as suspicious for cancer recurrence. Of 31 studies reporting MRI assessment criteria, the Prostate Imaging-Reporting and Data System (PI-RADS) score was the scheme used most often (20 studies; 65%), followed by a 5-point Likert score (six studies; 19%). For the consensus exercise, consensus for statements scored with agreement or disagreement increased from 227 of 295 statements (76.9%) in round one to 270 of 329 statements (82.1%) in round two. Key recommendations include performing routine MRI at 12 mo using a multiparametric protocol compliant with PI-RADS version 2.1 standards. PI-RADS category scores for assessing recurrence within the ablation zone should be avoided. An alternative 5-point scoring system is presented that includes a major dynamic contrast enhancement (DCE) sequence and joint minor diffusion-weighted imaging and T2-weighted sequences. For the DCE sequence, focal nodular strong early enhancement was the most suspicious imaging finding. A structured minimum reporting data set and minimum reporting standards for studies detailing MRI data after focal therapy are presented. The TARGET consensus recommendations may improve MRI acquisition, interpretation, and reporting after focal therapy for prostate cancer and provide minimum standards for study reporting. Magnetic resonance imaging (MRI) scans can detect recurrent of prostate cancer after focal treatments, but there is a lack of guidance on MRI use for this purpose. We report new expert recommendations that may improve practice.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
Magnetic resonance imaging (MRI) can detect recurrences after focal therapy for prostate cancer but there is no robust guidance regarding its use. Our objective was to produce consensus recommendations on MRI acquisition, interpretation, and reporting after focal therapy.
METHODS METHODS
A systematic review was performed in July 2022 to develop consensus statements. A two-round consensus exercise was then performed, with a consensus meeting in January 2023, during which 329 statements were scored by 23 panellists from Europe and North America spanning urology, radiology, and pathology with experience across eight focal therapy modalities. Using RAND Corporation/University of California-Los Angeles methodology, the Transatlantic Recommendations for Prostate Gland Evaluation with MRI after Focal Therapy (TARGET) were based on consensus for statements scored with agreement or disagreement.
KEY FINDINGS AND LIMITATIONS UNASSIGNED
In total, 73 studies were included in the review. All 20 studies (100%) reporting suspicious imaging features cited focal contrast enhancement as suspicious for cancer recurrence. Of 31 studies reporting MRI assessment criteria, the Prostate Imaging-Reporting and Data System (PI-RADS) score was the scheme used most often (20 studies; 65%), followed by a 5-point Likert score (six studies; 19%). For the consensus exercise, consensus for statements scored with agreement or disagreement increased from 227 of 295 statements (76.9%) in round one to 270 of 329 statements (82.1%) in round two. Key recommendations include performing routine MRI at 12 mo using a multiparametric protocol compliant with PI-RADS version 2.1 standards. PI-RADS category scores for assessing recurrence within the ablation zone should be avoided. An alternative 5-point scoring system is presented that includes a major dynamic contrast enhancement (DCE) sequence and joint minor diffusion-weighted imaging and T2-weighted sequences. For the DCE sequence, focal nodular strong early enhancement was the most suspicious imaging finding. A structured minimum reporting data set and minimum reporting standards for studies detailing MRI data after focal therapy are presented.
CONCLUSIONS AND CLINICAL IMPLICATIONS CONCLUSIONS
The TARGET consensus recommendations may improve MRI acquisition, interpretation, and reporting after focal therapy for prostate cancer and provide minimum standards for study reporting.
PATIENT SUMMARY RESULTS
Magnetic resonance imaging (MRI) scans can detect recurrent of prostate cancer after focal treatments, but there is a lack of guidance on MRI use for this purpose. We report new expert recommendations that may improve practice.

Identifiants

DOI: 10.1016/j.eururo.2024.02.001 PMID: 38519280
pubmed: 38519280
pii: S0302-2838(24)00067-8
doi: 10.1016/j.eururo.2024.02.001
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.

Auteurs

Alexander Light (A)

Imperial Prostate, Department of Surgery and Cancer, Imperial College London, London, UK; Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.

Nikhil Mayor (N)

Imperial Prostate, Department of Surgery and Cancer, Imperial College London, London, UK; Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.

Emma Cullen (E)

Imperial Prostate, Department of Surgery and Cancer, Imperial College London, London, UK.

Alex Kirkham (A)

Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK; Centre for Medical Imaging, Division of Medicine, University College London, London, UK.

Anwar R Padhani (AR)

Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, UK.

Manit Arya (M)

Imperial Prostate, Department of Surgery and Cancer, Imperial College London, London, UK; Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.

Joyce G R Bomers (JGR)

Department of Medical Imaging, Radboud University Medical Center, Nijmegen, The Netherlands.

Tim Dudderidge (T)

Department of Urology, University Hospital Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Behfar Ehdaie (B)

Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.

Alex Freeman (A)

Department of Pathology, University College London Hospitals NHS Foundation Trust, London, UK.

Stephanie Guillaumier (S)

Department of Urology, Victoria Hospital, NHS Fife, Kirkcaldy, UK.

Richard Hindley (R)

Department of Urology, Basingstoke and North Hampshire Hospital, Hampshire Hospitals NHS Foundation Trust, Basingstoke, UK.

Amish Lakhani (A)

Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, UK; Department of Imaging, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK; Department of Surgery and Cancer, Imperial College London, London, UK.

Douglas Pendse (D)

Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK; Centre for Medical Imaging, Division of Medicine, University College London, London, UK.

Shonit Punwani (S)

Department of Radiology, University College London Hospitals NHS Foundation Trust, London, UK; Centre for Medical Imaging, Division of Medicine, University College London, London, UK.

Ardeshir R Rastinehad (AR)

The Smith Institute for Urology at Lenox Hill, New York, NY, USA.

Olivier Rouvière (O)

Department of Vascular and Urinary Imaging, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France; Faculté de Médecine, Université de Lyon, Lyon, France.

Rafael Sanchez-Salas (R)

Division of Urology, Department of Surgery, McGill University, Montreal, Canada.

Ivo G Schoots (IG)

Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands; Department of Radiology, Netherlands Cancer Institute, Amsterdam, The Netherlands.

Heminder K Sokhi (HK)

Paul Strickland Scanner Centre, Mount Vernon Cancer Centre, Northwood, UK; Department of Radiology, The Hillingdon Hospitals NHS Foundation Trust, London, UK.

Henry Tam (H)

Department of Imaging, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.

Clare M Tempany (CM)

Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Massimo Valerio (M)

Department of Urology, Geneva University Hospitals, Geneva, Switzerland.

Sadhna Verma (S)

Department of Radiology, University of Cincinnati Medical Center, Cincinnati, OH, USA.

Geert Villeirs (G)

Department of Radiology and Nuclear Medicine, Ghent University Hospital, Ghent, Belgium.

Jan van der Meulen (J)

Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK.

Hashim U Ahmed (HU)

Imperial Prostate, Department of Surgery and Cancer, Imperial College London, London, UK; Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK.

Taimur T Shah (TT)

Imperial Prostate, Department of Surgery and Cancer, Imperial College London, London, UK; Imperial Urology, Charing Cross Hospital, Imperial College Healthcare NHS Trust, London, UK. Electronic address: t.shah@imperial.ac.uk.

Classifications MeSH