The role for MRI-guided transurethral ultrasound ablation in the continuum of prostate cancer care.

Prostate cancer continues to have a negative impact on the duration and quality of life for males and their families. MRI is transforming the pathway of prostate cancer detection, diagnosis, staging, and surveillance, backed by multiple Level 1 studies and robust reporting standards. This evolving paradigm of MRI-directed care is now being expanded to include in-bore MRI-guided prostate tissue ablation techniques, which reduce the burden of genitourinary complications associated with standard-of-care treatments, without sacrificing cancer control. The workflow for MRI-guided transurethral ultrasound ablation relies on intraprocedural MRI guidance for treatment planning, automated and physician-monitored treatment delivery, and post-treatment assessment at both immediate and long-term time points. Our early experience has identified several procedure refinements, and aligns with early evidence from prospective clinical studies using transurethral ultrasound ablation for treatment of patients with either primary or recurrent disease. Driven by quantitative real-time imaging, MRI-guided ablative interventions provide rich datasets for developing technical refinements and predictive models that will progressively improve patient outcomes as these novel techniques become part of a new standard-of-care.

Oncologically Relevant Findings Reporting and Data System (ONCO-RADS): Guidelines for the Acquisition, Interpretation, and Reporting of Whole-Body MRI for Cancer Screening.

Acknowledging the increasing number of studies describing the use of whole-body MRI for cancer screening, and the increasing number of examinations being performed in patients with known cancers, an international multidisciplinary expert panel of radiologists and a geneticist with subject-specific expertise formulated technical acquisition standards, interpretation criteria, and limitations of whole-body MRI for cancer screening in individuals at higher risk, including those with cancer predisposition syndromes. The Oncologically Relevant Findings Reporting and Data System (ONCO-RADS) proposes a standard protocol for individuals at higher risk, including those with cancer predisposition syndromes. ONCO-RADS emphasizes structured reporting and five assessment categories for the classification of whole-body MRI findings. The ONCO-RADS guidelines are designed to promote standardization and limit variations in the acquisition, interpretation, and reporting of whole-body MRI scans for cancer screening. Published under a CC BY 4.0 license Online supplemental material is available for this article.