Magnetic resonance imaging (MRI) can detect recurrences after focal therapy for prostate cancer but there is no robust guidance regarding its use. Our objective was to produce consensus recommendations on MRI acquisition, interpretation, and reporting after focal therapy. A systematic review was performed in July 2022 to develop consensus statements. A two-round consensus exercise was then performed, with a consensus meeting in January 2023, during which 329 statements were scored by 23 panellists from Europe and North America spanning urology, radiology, and pathology with experience across eight focal therapy modalities. Using RAND Corporation/University of California-Los Angeles methodology, the Transatlantic Recommendations for Prostate Gland Evaluation with MRI after Focal Therapy (TARGET) were based on consensus for statements scored with agreement or disagreement. In total, 73 studies were included in the review. All 20 studies (100%) reporting suspicious imaging features cited focal contrast enhancement as suspicious for cancer recurrence. Of 31 studies reporting MRI assessment criteria, the Prostate Imaging-Reporting and Data System (PI-RADS) score was the scheme used most often (20 studies; 65%), followed by a 5-point Likert score (six studies; 19%). For the consensus exercise, consensus for statements scored with agreement or disagreement increased from 227 of 295 statements (76.9%) in round one to 270 of 329 statements (82.1%) in round two. Key recommendations include performing routine MRI at 12 mo using a multiparametric protocol compliant with PI-RADS version 2.1 standards. PI-RADS category scores for assessing recurrence within the ablation zone should be avoided. An alternative 5-point scoring system is presented that includes a major dynamic contrast enhancement (DCE) sequence and joint minor diffusion-weighted imaging and T2-weighted sequences. For the DCE sequence, focal nodular strong early enhancement was the most suspicious imaging finding. A structured minimum reporting data set and minimum reporting standards for studies detailing MRI data after focal therapy are presented. The TARGET consensus recommendations may improve MRI acquisition, interpretation, and reporting after focal therapy for prostate cancer and provide minimum standards for study reporting. Magnetic resonance imaging (MRI) scans can detect recurrent of prostate cancer after focal treatments, but there is a lack of guidance on MRI use for this purpose. We report new expert recommendations that may improve practice.

中文翻译：

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局部治疗后用磁共振成像评估前列腺的跨大西洋建议（TARGET）：系统回顾和国际共识建议

磁共振成像（MRI）可以检测前列腺癌局部治疗后的复发情况，但对其使用尚无强有力的指导。我们的目标是就局部治疗后的 MRI 采集、解释和报告提出共识建议。 2022 年 7 月进行了系统审查以制定共识声明。随后进行了两轮共识练习，并于 2023 年 1 月召开了共识会议，会议期间，来自欧洲和北美的 23 名小组成员对 329 份声明进行了评分，这些小组成员涉及泌尿学、放射学和病理学，具有八种局部治疗方式的经验。使用兰德公司/加州大学洛杉矶分校的方法，局部治疗后用 MRI 进行前列腺评估的跨大西洋建议 (TARGET) 基于对同意或不同意的陈述的共识。总共有 73 项研究被纳入该评价。报告可疑影像学特征的所有 20 项研究 (100%) 都将局部对比增强视为癌症复发的可疑因素。在报告 MRI 评估标准的 31 项研究中，前列腺成像报告和数据系统 (PI-RADS) 评分是最常用的方案（20 项研究；65%），其次是 5 分 Likert 评分（6 项研究；19%） ）。对于共识练习，同意或不同意的声明的共识从第一轮 295 条声明中的 227 条 (76.9%) 增加到第二轮 329 条声明中的 270 条 (82.1%)。主要建议包括使用符合 PI-RADS 2.1 版标准的多参数协议在 12 个月时进行常规 MRI。应避免用于评估消融区内复发的 PI-RADS 类别评分。提出了另一种 5 点评分系统，其中包括主要动态对比度增强 (DCE) 序列以及联合次要扩散加权成像和 T2 加权序列。对于 DCE 序列，局灶性结节性强早期强化是最可疑的影像学发现。提出了详细说明局部治疗后 MRI 数据的研究的结构化最低报告数据集和最低报告标准。 TARGET 共识建议可能会改善前列腺癌局部治疗后的 MRI 采集、解释和报告，并为研究报告提供最低标准。磁共振成像 (MRI) 扫描可以检测局部治疗后前列腺癌的复发情况，但缺乏关于 MRI 用于此目的的指导。我们报告了可能改进实践的新专家建议。