THE ROLE OF MULTIPARAMETRIC RESONANCE IN THE MULTIDISCIPLINARY TEAM FOR PROSTATE CANCER

Carmen Maccagnano1, Filippo Bianchi1, Matteo Corinti1, Vanessa Lancini1, Giario Natale Conti1
  • 1 ASST Lariana Ospedale Sant'Anna (San Fermo della Battaglia )

Objective

Multi-Parametric Magnetic Resonance Imaging (MP-MRI) may improve the detection of clinically significant prostate cancer (PCa). Thus, the exam may be extremely useful in the context of multi-disciplinary team (MDT) of prostate cancer unit (PCU). We analyzed the clinical significance of MP-MRI in the context of the PCU of our Centre during 2015. Additionally, we compared our experience with those reported in literature.

Materials and Methods

We analyzed the story of patients (pts) followed by PCU, constituted by an Urologist, a Medical Oncologist and a Radiation Oncologist during 2015. All the patients executed MP-MRI.
Moreover, we reviewed literature using Medline, Embase and Cochrane Library with the key words: “Prostate Cancer”, “Multi-Disciplinary Team “, “Multi-parametric Magnetic Resonance”

Results

120 pts with PCa were followed by PCU in 2015 in Our Centre. They all executed mp-MRI. The pts’ main features were reported in table 1. The main indication for mp-MRI was surveillance because both of pre-neoplastic lesions, and elevated PSA level and active surveillance protocol itself (Figure 1).

Discussions

The clinical utility of MP-MRI, defined as the ability to change the management of the pts was about 57%. The details are reported in table 2.

Since its beginning in 2014, the total cost of MP-MRI in the context of PCU was about € 30.256,8. The mean annual cost was about € 15.128.We considered these costs as adequate relating to the clinical advantages.
According to the most recent literature, mp-MRI plays a fundamental role in the management of the pts by the MTD of PCU.

Conclusion

Mp-MRI is an important exam for the diagnosis, therapy and follow-up of pts in the context of PCU. The costs are not so high and well balanced by the clinical advantages. Additional perspectives trials are necessary to confirm these data as well as Specialists dedicated PCa, including members of PCU, an Uro-Radiologist and a Pathologist.

Reference

Lebacle C, Roudot-Thoraval F, Moktefi A, Bouanane M, De La Taille A, Salomon L. Integration of MRI to clinical nomogram for predicting pathological stage before radical prostatectomy. World J Urol. 2016 Dec 19.

Moghanaki D, Turkbey B, Vapiwala N, Ehdaie B, Frank SJ, McLaughlin PW, Harisinghani M. Advances in Prostate Cancer Magnetic Resonance Imaging and Positron Emission Tomography-Computed Tomography for Staging and Radiotherapy Treatment Planning. Semin Radiat Oncol 2017; 27(1): 21-33.

Tsivian M, Gupta RT, Tsivian E, Qi P, Mendez MH, Abern MR, Tay KJ, Polascik TJ. Assessing clinically significant prostate cancer: Diagnostic properties of multiparametric magnetic resonance imaging compared to three-dimensional transperineal template mapping histopathology. Int J Urol. 2016 Nov 8. doi: 10.1111/iju.13251.

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