low-up multiparametric MRI study that was performed after active surveillance began.
Prostate cancer is known to be slow growing for many men,
and most malignancies diagnosed will remain clinically insignificant. Clinicians developed the active surveillance approach to
monitor indolent disease and delay the need for definitive treatment, which may carry significant risk of genitourinary morbidity. While this treatment option has proved to be safe in men with
early-stage prostate cancer for up to 15 years, there is no consensus about the optimal protocol for men being monitored with active surveillance.
Further prospective studies including large cohort sample
sizes are necessary to validate the role of multiparametric MRI
in the management of prostate cancer.
Role of CT in the Diagnosis of
Nonspecific Abdominal Pain: A
With the exception of physicians’
confidence before CT, other specific
patient and physician factors known
before CT referral are not associated
with final diagnosis of nonspecific abdominal pain (NSAP), according to a
prospective multicenter study.
The researchers surveyed physicians before and after CT to identify
changes in leading diagnoses, diagnostic confidence, and admission decisions. They conducted a multiple regression analysis to
identify whether the following were associated with a diagnosis of
NSAP after CT: patient age, patient sex, physicians’ years of experience, physicians’ diagnostic confidence before CT, and physicians’
admission decision before CT if CT had not been available.
“We identified a few factors that may be useful to explore in
further research, however our findings suggest no simple way to
AJR in Brief: Interpretive Errors
and Medical Mimics of Child Abuse
Among Highlighted Articles
The March, April, and May articles published in AJR provide cutting-edge information across various topics and chal- lenges relevant to today’s radiologists. Some of the notable
studies consider CT in the diagnosis of nonspecific abdominal
pain, CT colonographic screening of patients with a family history of colorectal cancer, and imaging characteristics of certain
prostate cancer patients. Study authors also discuss interpretive
errors in radiology, diseases that mimic child abuse, and lung
cancers manifesting as part-solid nodules. Here’s a brief overview of a few selected articles.
Imaging Characteristics of
Prostate Cancer Patients Who
Surveillance on 3-T
Multiparametric Prostate MRI
Multiparametric MRI is useful in
monitoring early-stage prostate cancer
patients on active surveillance and may
identify patients with clinically significant disease amenable to definitive treatment. The findings were published in a
study that reviewed a small cohort of
patients monitored at the department of urology at Winthrop
University Hospital, Mineola, NY.
Winthrop’s active surveillance regimen uses annual MRI in
place of serial biopsies, and biopsies are performed only when clinically necessary, the study said. The objective was to report the
multiparametric MRI characteristics of prostate cancer patients
who discontinued active surveillance at the institution after repeat
imaging revealed possible evidence of tumor upgrading.
At the time of this study, there were 200 prostate cancer patients being monitored with active surveillance. Of those patients, 114 had an initial multiparametric MRI study that was
performed before active surveillance started and at least one fol-
While this treatment option has proved to be
safe in men with early-stage prostate cancer
for up to 15 years, there is no consensus about
the optimal protocol for men being monitored
with active surveillance.—Aaron E. Katz
Aaron E. Katz
We identified a few factors that may be useful
to explore in further research, however our
findings suggest no simple way to safely
eliminate the need for CT in patients who—
after CT—end up with a diagnosis of NSAP.—
Jonathan D. Eisenberg
Jonathan D. Eisenberg