A study of prostate cancer has found that MRI (magnetic resource imaging) evaluations can influence clinical decision-making for both physicians and patients, though whether those decisions result in superior outcomes remains unclear.
Accurate staging is extremely important for distinguishing patient risk factors and guiding treatment decision-making for prostate cancer. Although the use of MRI may play a role in disease management, they are not typically used for the diagnosis or staging of prostate cancer.
In an article published on Onclive, lead author Jonathan D Tward, MD, PhD, University of Utah (Salt Lake City, UT) and his coauthors investigated the role of MRIs in the clinical staging of prostate cancer in the definitive and salvage setting in order to determine whether use of the test led to any changes in treatment recommendations.
Authors looked at 114 patients who received a prostate protocol MRI between November 2008 and November 2011. A total of 86 patients received definitive treatment (standard care), and 26 received salvage treatment, a form of therapy delivered after the disease stops responding to standard therapy. Two patients were also evaluated for treatment planning in the adjuvant setting. If an MRI was used before radiotherapy consultation, only one set of recommendations was made. If MRI was performed after radiotherapy consultation, treatment recommendations were given at the time of radiotherapy consultation and then again after MRI results were obtained.
In the definitive group, 18 patients received MRIs before radiotherapy consultation. Of the 68 patients who received MRIs after consultation, 6 (~9%) had their recommendations changed after receiving the test results. Newly found nodal metastases were also detected by MRI in 6 of the 86 patients (~7%), and pelvic lymph nodes were judged to be concerning based on MRI results in an additional 2 patients (2.33%). In the 26 patients receiving salvage therapy, MRI evaluation did not lead to any changes in treatment.
From these results, the authors concluded that advanced imaging in prostate cancer staging and diagnosis could impact decision-making for patients receiving definitive treatment. In most cases, changes in treatment plans involved an escalated approach to care. More research will be needed to determine whether the additional information provided by MRI can lead to improved outcomes.
