Metastasis Reporting and Data System for Prostate Cancer in Practice

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Key points

  • MET-RADS provides the minimum standards for whole-body MR imaging with DWI regarding image acquisitions, interpretation, and reporting of baseline and follow-up monitoring examinations of patients with advanced, metastatic prostate cancers.

  • MET-RADS is suitable for guiding patient care in practice (using the regional and overall assessment criteria) but can also be incorporated into clinical trials when accurate lesion size and ADC measurements become more important.

  • MET-RADS enables the

Response Assessment Categories

An updated MET-RADS-P template form is found in Fig. 1. The use of MET-RADS-P system starts by allocating the presence of unequivocal identified disease based on morphology and signal characteristics on all acquired images to 14 predefined regions of the body (primary disease, seven skeletal and three nodal regions, lung, liver, and other soft tissue sites) at baseline and on follow-up assessments (MET-RADS-P template form Fig. 1).6

For follow-up studies, a qualitative response assessment on a

Worked-up examples

An updated MET-RADS-P template form and detailed bone response assessment criteria are found in Fig. 1 and Table 2. Fig. 2, Figs. 3, and 4 illustrate the use of the MET-RADS-P standard6 in advanced, metastatic prostate cancer illustrated with examples of disease progression, responding, and discordant responses. The figures also demonstrate the utility of the WB-tumor load segmentation which is undertaken on work-in-progress software (Siemens Healthineers, Erlangen, Germany). Note that tumor

Conclusions and future developments

The MET-RADS-P system provides the minimum standards for WB-MR imaging with DWI image acquisition, interpretation, and reporting of baseline and follow-up monitoring examinations of men with advanced, metastatic prostate cancer. MET-RADS-P is suitable for guiding patient care in practice (using the regional and overall assessment criteria), but can also be incorporated into clinical trials when accurate lesion size and ADC measurements become more important (thus, recording of measurements is

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