PRECISE Version 2: Updated Recommendations for Reporting Prostate Magnetic Resonance Imaging in Patients on Active Surveillance for Prostate Cancer

IF 25.3 1区医学 Q1 UROLOGY & NEPHROLOGY European urology Pub Date : 2024-09-01 DOI:10.1016/j.eururo.2024.03.014

{"title":"PRECISE Version 2: Updated Recommendations for Reporting Prostate Magnetic Resonance Imaging in Patients on Active Surveillance for Prostate Cancer","authors":"","doi":"10.1016/j.eururo.2024.03.014","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and objective</h3><p>The Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) recommendations standardise the reporting of prostate magnetic resonance imaging (MRI) in patients on active surveillance (AS) for prostate cancer. An international consensus group recently updated these recommendations and identified the areas of uncertainty.</p></div><div><h3>Methods</h3><p>A panel of 38 experts used the formal RAND/UCLA Appropriateness Method consensus methodology. Panellists scored 193 statements using a 1–9 agreement scale, where 9 means full agreement. A summary of agreement, uncertainty, or disagreement (derived from the group median score) and consensus (determined using the Interpercentile Range Adjusted for Symmetry method) was calculated for each statement and presented for discussion before individual rescoring.</p></div><div><h3>Key findings and limitations</h3><p>Participants agreed that MRI scans must meet a minimum image quality standard (median 9) or be given a score of ‘X’ for insufficient quality. The current scan should be compared with both baseline and previous scans (median 9), with the PRECISE score being the maximum from any lesion (median 8). PRECISE 3 (stable MRI) was subdivided into 3-V (visible) and 3-NonV (nonvisible) disease (median 9). Prostate Imaging Reporting and Data System/Likert ≥3 lesions should be measured on T2-weighted imaging, using other sequences to aid in the identification (median 8), and whenever possible, reported pictorially (diagrams, screenshots, or contours; median 9). There was no consensus on how to measure tumour size. More research is needed to determine a significant size increase (median 9). PRECISE 5 was clarified as progression to stage ≥T3a (median 9).</p></div><div><h3>Conclusions and clinical implications</h3><p>The updated PRECISE recommendations reflect expert consensus opinion on minimal standards and reporting criteria for prostate MRI in AS.</p></div>","PeriodicalId":12223,"journal":{"name":"European urology","volume":null,"pages":null},"PeriodicalIF":25.3000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0302283824022322/pdfft?md5=184b8d408f6e3148fcdfe14135f30a15&pid=1-s2.0-S0302283824022322-main.pdf","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European urology","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0302283824022322","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background and objective

The Prostate Cancer Radiological Estimation of Change in Sequential Evaluation (PRECISE) recommendations standardise the reporting of prostate magnetic resonance imaging (MRI) in patients on active surveillance (AS) for prostate cancer. An international consensus group recently updated these recommendations and identified the areas of uncertainty.

Methods

A panel of 38 experts used the formal RAND/UCLA Appropriateness Method consensus methodology. Panellists scored 193 statements using a 1–9 agreement scale, where 9 means full agreement. A summary of agreement, uncertainty, or disagreement (derived from the group median score) and consensus (determined using the Interpercentile Range Adjusted for Symmetry method) was calculated for each statement and presented for discussion before individual rescoring.

Key findings and limitations

Participants agreed that MRI scans must meet a minimum image quality standard (median 9) or be given a score of ‘X’ for insufficient quality. The current scan should be compared with both baseline and previous scans (median 9), with the PRECISE score being the maximum from any lesion (median 8). PRECISE 3 (stable MRI) was subdivided into 3-V (visible) and 3-NonV (nonvisible) disease (median 9). Prostate Imaging Reporting and Data System/Likert ≥3 lesions should be measured on T2-weighted imaging, using other sequences to aid in the identification (median 8), and whenever possible, reported pictorially (diagrams, screenshots, or contours; median 9). There was no consensus on how to measure tumour size. More research is needed to determine a significant size increase (median 9). PRECISE 5 was clarified as progression to stage ≥T3a (median 9).

Conclusions and clinical implications

The updated PRECISE recommendations reflect expert consensus opinion on minimal standards and reporting criteria for prostate MRI in AS.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

PRECISE 第 2 版：关于前列腺癌主动监测患者前列腺磁共振成像报告的最新建议。

背景和目的：前列腺癌放射学序列评估（PRECISE）建议规范了前列腺癌主动监测（AS）患者的前列腺磁共振成像（MRI）报告。最近，一个国际共识小组对这些建议进行了更新，并确定了存在不确定性的领域：一个由 38 位专家组成的小组采用了正式的兰德/加州大学洛杉矶分校适当性方法（RAND/UCLA Appropriateness Method）共识方法。专家小组成员采用 1-9 分的同意度对 193 项陈述进行评分，其中 9 分表示完全同意。针对每项陈述计算出同意、不确定或不同意（根据小组中位数得分得出）以及共识（使用经对称性调整的百分位间范围法确定）的汇总结果，并在个人重新评分前提交讨论：与会者一致认为，磁共振成像扫描必须达到最低图像质量标准（中位数为 9），否则将被打 "X "分，表示质量不佳。当前扫描应与基线扫描和先前扫描进行比较（中位数为 9），PRECISE 分数为任何病变的最高分（中位数为 8）。PRECISE 3（稳定的 MRI）又分为 3-V（可见）和 3-NonV（非可见）疾病（中位数 9）。前列腺成像报告和数据系统/Likert ≥3病变应在T2加权成像上测量，使用其他序列帮助识别（中位数为8），并尽可能以图像（图表、截图或轮廓；中位数为9）报告。关于如何测量肿瘤大小，尚未达成共识。需要进行更多的研究，以确定肿瘤的显著增大（中位数 9）。PRECISE 5明确为进展至≥T3a期（中位数9）：更新后的 PRECISE 建议反映了专家对强直性脊柱炎前列腺 MRI 最低标准和报告标准的共识意见。患者摘要：前列腺癌放射学序列评估（PRECISE）建议用于临床实践和研究，以指导前列腺癌主动监测患者磁共振成像的解释和报告。一个国际专家小组对这些建议进行了更新，澄清了存在不确定性的领域，并强调了需要进一步研究的领域。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

European urology 医学-泌尿学与肾脏学

CiteScore

43.00

自引率

2.60%

发文量

1753

审稿时长

23 days

期刊介绍： European Urology is a peer-reviewed journal that publishes original articles and reviews on a broad spectrum of urological issues. Covering topics such as oncology, impotence, infertility, pediatrics, lithiasis and endourology, the journal also highlights recent advances in techniques, instrumentation, surgery, and pediatric urology. This comprehensive approach provides readers with an in-depth guide to international developments in urology.