Abstract
Magnetic resonance imaging (MRI) has transformed the diagnostic pathway for prostate cancer and now plays an upfront role before prostate biopsies. If a suspicious lesion is found on MRI, the subsequent biopsy can be targeted. A sharp increase is expected in the number of men who will undergo prostate MRI. The challenge is to provide good image quality and diagnostic accuracy while meeting the demands of the expected higher workload. A possible solution to this challenge is to include a suitable risk stratification tool before imaging. Other solutions, such as smarter and shorter MRI protocols, need to be explored. For most of these solutions, artificial intelligence (AI) can play an important role. AI applications have the potential to improve the diagnostic quality of the prostate MRI pathway and speed up the work. Patient summaryThe use of prostate magnetic resonance imaging (MRI) for diagnosis of prostate cancer is increasing. Risk stratification of patients before imaging and the use of shorter scan protocols can help in managing MRI resources. Artificial intelligence can also play a role in automating some tasks.
Highlights
Magnetic resonance imaging (MRI) has transformed the diagnostic pathway for prostate cancer and plays an upfront role before prostate biopsies
In 2012, the United States Preventive Services Task Force recommended against the use of a serum prostate-specific antigen (PSA)-based screening program for prostate cancer (PCa) because the expected disadvantages outweigh the possible advantages [1]
These recommendations were based on a conventional diagnostic strategy, in which systematic transrectal ultrasound (TRUS)-guided biopsies were used to find the cause of the elevated PSA without the use of risk stratification tools such as multivariable risk calculators and prostate magnetic resonance imaging (MRI)
Summary
In 2012, the United States Preventive Services Task Force recommended against the use of a serum prostate-specific antigen (PSA)-based screening program for PCa because the expected disadvantages outweigh the possible advantages [1]. Similar recommendations were included in the European Association of Urology (EAU) guidelines [2]. These recommendations were based on a conventional diagnostic strategy, in which systematic transrectal ultrasound (TRUS)-guided biopsies were used to find the cause of the elevated PSA without the use of risk stratification tools such as multivariable risk calculators and prostate magnetic resonance imaging (MRI). MRI is not used in a formal screening setting, the increased use of diagnostic tests will lead to challenges in providing good image quality and diagnostic accuracy while meeting the demands of the expected higher workload. We discuss the role that artificial intelligence (AI) might play in this clinical setting
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