In recent years, recommendations for prostate cancer screening have been caught amidst growing controversy. The utility of prostate-specific antigen (PSA) testing, the most prominent front-line screening exam for prostate cancer has been heavily critiqued. Meanwhile, numerous men present with incurable late-stage prostate cancer while men with low-risk, indolent disease receive treatment that offers little benefit in terms of health outcomes.

In a recent study, researchers looked into 12-year follow-up results to the Finnish Prostate Cancer Screening Trial to evaluate the relationship between prostate cancer screening and family history. Although family history is a known risk factor for developing prostate cancer, they curiously found no benefits to selectively screening men based on family history alone.

New clinical imaging guidelines for the interpretation of prostate MRI exams have been released. A joint steering committee organized by the American College of Radiology, AdMeTech Foundation and European Society of Urogenital Radiology (ESUR) developed Prostate Imaging Reporting and Data System (PI-RADS) Version-2.

Multiparametric magnetic resonance imaging (MRI) and MRI-guided prostate biopsy are emerging as useful applications in the detection of prostate cancer. Transrectal ultrasound (TRUS) biopsy, the current traditional method of diagnosis prostate cancer, can result in sampling errors that lead to delayed diagnosis or misclassification of cancers.

As you are aware, Rolling Oaks Radiology is one of the most active and experienced prostate MRI centers in the country. This letter is to inform you about recent PIRADS assessment changes for the interpretation of prostate MRI exams.

PIRADS, initially developed in Europe, has been the international accepted interpretation standard for the past two years. These recent changes were announced by our joint steering committee at the annual meeting of the RSNA in November.

While most prostate cancers grow slowly and may require only minimal treatment, others are aggressive and early detection of these cancers is essential to achieving optimal outcomes. Accurately diagnosing prostate cancer early can be an immense challenge. Digital rectal exam (DRE), prostate-specific antigen (PSA) tests and transrectal ultrasound-guided (TRUS) biopsy — tools traditionally used to diagnose prostate cancer — have limitations that the medical community has long sought to overcome.