Magnetic resonance imaging in patients with a raised PSA and a negative biopsy

Our study of the results of MRI in patients either on active surveillance or having prior negative biopsies and an elevated PSA  is important. We believe we have identified aggressive prostate cancers among such men whom represent a sub-group of anterior tumours that easily fit a syndrome when combined with data from other series: PEATS: PROSTATIC EVASIVE ANTERIOR TUMOURS. This warrants further study as these evasive tumours are anteriorly located  and detectable via MRI when standard biopsy techniques have failed. When discrepancy between PSA, PSA dynamics and either a negative biopsy or low volume prostate cancer managed by active surveillance: think of anterior tumours and think of MRI. These tumours are actually fairly aggressive and physicians should be aware of their behaviour. Further research is encouraged to better delineate the prevalence of this condition and how to better detect it earlier in disease ontogeny

Bibliographic Reference

Lawrentschuk N et al.: "'Prostatic evasive anterior tumours': the role of magnetic resonance imaging", BJU Int. 2009 Oct 8. [Epub ahead of print]

Nathan Lawrentschuk and Neil Fleshner

Department of Urology and Joint, University Health Network, University of Toronto, Toronto, ON, Canada