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METastasis Reporting and Data System for Prostate Cancer: Practical Guidelines for Acquisition, Interpretation, and Reporting of Whole-body Magnetic Resonance Imaging-based Evaluations of Multiorgan Involvement in Advanced Prostate Cancer

Abstract

Context

Comparative reviews of whole-body magnetic resonance imaging (WB-MRI) and positron emission tomography/computed tomography (CT; with different radiotracers) have shown that metastasis detection in advanced cancers is more accurate than with currently used CT and bone scans. However, the ability of WB-MRI and positron emission tomography/CT to assess therapeutic benefits has not been comprehensively evaluated. There is also considerable variability in the availability and quality of WB-MRI, which is an impediment to clinical development. Expert recommendations for standardising WB-MRI scans are needed, in order to assess its performance in advanced prostate cancer (APC) clinical trials.

Objective

To design recommendations that promote standardisation and diminish variations in the acquisition, interpretation, and reporting of WB-MRI scans for use in APC.

Evidence acquisition

An international expert panel of oncologic imagers and oncologists with clinical and research interests in APC management assessed biomarker requirements for clinical care and clinical trials. Key requirements for a workable WB-MRI protocol, achievable quality standards, and interpretation criteria were identified and synthesised in a white paper.

Evidence synthesis

The METastasis Reporting and Data System for Prostate Cancer guidelines were formulated for use in all oncologic manifestations of APC.

Conclusions

Uniformity in imaging data acquisition, quality, and interpretation of WB-MRI are essential for assessing the test performance of WB-MRI. The METastasis Reporting and Data System for Prostate Cancer standard requires validation in clinical trials of treatment approaches in APC.

Patient summary

METastasis Reporting and Data System for Prostate Cancer represents the consensus recommendations on the performance, quality standards, and reporting of whole-body magnetic resonance imaging, for use in all oncologic manifestations of advanced prostate cancer. These new criteria require validation in clinical trials of established and new treatment approaches in advanced prostate cancer.

Take Home Message

Bone/computed tomography scans are limited for detection and response assessment of bone disease in advanced prostate cancer. METastasis Reporting and Data System for Prostate Cancer is the new performance and quality standard for whole-body magnetic resonance imaging, for use in all oncologic manifestations of advanced prostate cancer.

Keywords: Advanced prostate cancer, Guidelines, Metastatic castrate-resistant prostate cancer, Whole-body MRI, Diffusion MRI, Response assessment, Clinical trials.

Footnotes

a Paul Strickland Scanner Centre, Mount Vernon Hospital, Middlesex, UK

b Department of Radiology, Centre du Cancer and Institut de Recherche Expérimentale et Clinique, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium

c Cancer Research UK Cancer Imaging Centre, Institute of Cancer Research and Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK

d Department of Radiology, Medical Imaging Research Centre, University Hospitals Leuven, Leuven, Belgium

e Department of Radiology, Memorial Sloan-Kettering Cancer Centre, New York, NY, USA

f Department of Radiology, German Cancer Research Centre Heidelberg (DKFZ), Heidelberg, Germany

g Department of Radiology, European Institute of Oncology, Milan, Italy

h Service of Nuclear Medicine, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy

i Department of Urology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium

j Drug Development Unit, Institute of Cancer Research and The Royal Marsden NHS Trust, Sutton, Surrey, UK

Corresponding author. Paul Strickland Scanner Centre, Mount Vernon Hospital, Rickmansworth Road, Northwood, Middlesex HA6 2RN, UK. Tel. +44-(0)-923-844751; fax: +44 0 1923 844600.