The value of MRI in active surveillance of prostate cancer.

Objective: to determine if the incorporation of Multimodality MRI including MRGB within the PRIAS study for low-risk low volume prostate cancer leads to a higher number of cancers that is upgraded by follow-up MRGB versus initial TRUSGB ( at 2 months, one year and four years of follow-up) in comparison to upgrading of cancers by follow-up TRUSGB versus initial TRUSGB ( at one and four years of follow-up).


Study population: Patients included in the PRIAS study
Intervention All the patients will undergo active surveillance with TRUSGB, MRI and MRGB at 2 months ( not for TRUSGB), one year and four years of follow-up with further MRI diagnostics in between if necessary.
A minimum of 19 visits, depending on the follow-up time, to the Radboud University Nijmegen medical centre, where TRUSGB, MRI and MRGB will be performed (6), and to the primary health care centre where the patients own urologist is based, to take venapunctions, digital rectal examinations and evaluations (13).

Incorporation of multimodality MRI will improve patient selection and will lead to earlier detection of patients with progressive disease in active surveillance within the PRIAS study, thus increasing patient safety. In this way, active surveillance will be reliable in preventing overtreatment ( incontinence, impotence).

Mainly after 2 months, one year and four years(=total follow-up) of folluw-up.

1. PCA3 testing;

2. Magnetic resonance imaging of the prostate;

3. Magnetic resonance imaging guided prostate;

4. Biopsy.