{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T03:18:49Z","timestamp":1783653529795,"version":"3.55.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"7","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"abstract":"<jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>MRI-based T-staging in prostate cancer enables more precise and individualised treatment decisions compared with traditional clinical T-staging, yet inconsistent image acquisition, interpretation, and terminology limit reproducibility and clinical integration. This report recommends standardising MRI-based T-staging to strengthen its prognostic and therapeutic relevance. The prefix \u201cmr\u201d for MRI-based T-staging should be used, together with \u201cextraprostatic extension\u201d as the official radiologic term, replacing \u201cextracapsular extension\u201d, to ensure consistency with pathology and the UICC TNM system. Within mrT3a disease, radiologists should differentiate \u201cfocal\u201d from \u201cestablished\u201d extraprostatic extension, as established disease carries a higher recurrence risk and often requires more extensive surgical or radiotherapeutic management. Quality assurance programs, standardised acquisition protocols, and targeted education for radiologists and technologists are essential for improving interinstitutional consistency. Clinicians should incorporate proposed terminology and focal\/established subclassification into structured reports and multidisciplinary discussions to refine risk stratification and guide nerve-sparing surgery or adjuvant therapy decisions. These coordinated measures will enhance the reproducibility and prognostic value of MRI-based T-staging, reduce overtreatment, and improve patient outcomes in contemporary prostate cancer management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Points<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>\n                            <jats:italic>The prefix \u201cmr\u201d should be added to T-staging for reporting and multidisciplinary team guidance, distinguishing it from clinical and pathological T-staging; extraprostatic extension should be explicitly defined as mrT3a.<\/jats:italic>\n                          <\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>\n                            <jats:italic>Staging assessment should be refined by subclassifying focal versus established extraprostatic extension to better guide risk stratification and treatment decisions.<\/jats:italic>\n                          <\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\n                            <jats:italic>More reproducible and objective criteria of MRI-derived parameters should be adopted to reduce interpretation variability and to improve reader reproducibility.<\/jats:italic>\n                          <\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00330-026-12397-8","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T16:16:37Z","timestamp":1771604197000},"page":"5745-5754","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["ESR Essentials: MRI-based T-staging in prostate cancer\u2014practice recommendations by the European Society of Urogenital Radiology"],"prefix":"10.1007","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3752-1315","authenticated-orcid":false,"given":"Georgios","family":"Agrotis","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9042-7328","authenticated-orcid":false,"given":"Fredrik","family":"J\u00e4derling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amish","family":"Lakhani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6113-0541","authenticated-orcid":false,"given":"Ana Sofia L.","family":"Moreira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maka","family":"Kekelidze","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justyna","family":"Rembak-Szynkiewicz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5343-6869","authenticated-orcid":false,"given":"Vibeke","family":"Logager","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harriet","family":"Thoeny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geert","family":"Villeirs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8459-8369","authenticated-orcid":false,"given":"Sungmin","family":"Woo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9804-0603","authenticated-orcid":false,"given":"Ivo G.","family":"Schoots","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"12397_CR1","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1016\/j.eururo.2014.06.015","volume":"67","author":"BC Jeong","year":"2015","unstructured":"Jeong BC, Chalfin HJ, Lee SB et al (2015) The relationship between the extent of extraprostatic extension and survival following radical prostatectomy. Eur Urol 67:342\u2013346. https:\/\/doi.org\/10.1016\/j.eururo.2014.06.015","journal-title":"Eur Urol"},{"key":"12397_CR2","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1016\/j.eururo.2024.03.027","volume":"86","author":"P Cornford","year":"2024","unstructured":"Cornford P, Van Den Bergh RCN, Briers E et al (2024) EAU-EANM-ESTRO-ESUR-ISUP-SIOG guidelines on prostate cancer\u20142024 update. Part I: Screening, diagnosis, and local treatment with curative intent. Eur Urol 86:148\u2013163. https:\/\/doi.org\/10.1016\/j.eururo.2024.03.027","journal-title":"Eur Urol"},{"key":"12397_CR3","doi-asserted-by":"publisher","unstructured":"Agrotis G, Woo S, J\u00e4derling F et al (2025) Radiological T-staging in prostate cancer: towards a universal MRI-based scoring system. Eur J Radiol. https:\/\/doi.org\/10.1016\/j.ejrad.2025.112363","DOI":"10.1016\/j.ejrad.2025.112363"},{"key":"12397_CR4","doi-asserted-by":"publisher","unstructured":"Eastham JA, Auffenberg GB, Barocas DA et al (2022) Clinically localized prostate cancer: AUA\/ASTRO guideline, Part I: Introduction, risk assessment, staging, and risk-based management. J Urol. https:\/\/doi.org\/10.1097\/JU.0000000000002757","DOI":"10.1097\/JU.0000000000002757"},{"key":"12397_CR5","doi-asserted-by":"publisher","first-page":"26","DOI":"10.1038\/modpathol.2010.158","volume":"24","author":"C Magi-Galluzzi","year":"2011","unstructured":"Magi-Galluzzi C, Evans AJ, Delahunt B et al (2011) International Society of Urological Pathology (ISUP) consensus conference on handling and staging of radical prostatectomy specimens. Working group 3: extraprostatic extension, lymphovascular invasion and locally advanced disease. Mod Pathol 24:26\u201338. https:\/\/doi.org\/10.1038\/modpathol.2010.158","journal-title":"Mod Pathol"},{"key":"12397_CR6","unstructured":"Brierley J, Giuliani M, O\u2019Sullivan B et al (2025) TNM classification of malignant tumours, Ninth edition. Wiley, Hoboken"},{"key":"12397_CR7","doi-asserted-by":"publisher","first-page":"405","DOI":"10.1016\/j.eururo.2023.02.002","volume":"83","author":"R Seifert","year":"2023","unstructured":"Seifert R, Emmett L, Rowe SP et al (2023) Second version of the prostate cancer molecular imaging standardized evaluation framework including response evaluation for clinical trials (PROMISE V2). Eur Urol 83:405\u2013412. https:\/\/doi.org\/10.1016\/j.eururo.2023.02.002","journal-title":"Eur Urol"},{"key":"12397_CR8","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1097\/00000478-198901000-00003","volume":"13","author":"AG Ayala","year":"1989","unstructured":"Ayala AG, Ro JY, Babaian R et al (1989) The prostatic capsule: does it exist? Its importance in the staging and treatment of prostatic carcinoma. Am J Surg Pathol 13:21\u201327","journal-title":"Am J Surg Pathol"},{"key":"12397_CR9","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1148\/radiol.210875","volume":"302","author":"AG Wibmer","year":"2022","unstructured":"Wibmer AG, Nikolovski I, Chaim J et al (2022) Local extent of prostate cancer at MRI versus prostatectomy histopathology: associations with long-term oncologic outcomes. Radiology 302:595\u2013602. https:\/\/doi.org\/10.1148\/radiol.210875","journal-title":"Radiology"},{"key":"12397_CR10","doi-asserted-by":"publisher","first-page":"597","DOI":"10.2214\/AJR.19.21836","volume":"214","author":"S Woo","year":"2020","unstructured":"Woo S, Han S, Kim T-H et al (2020) Prognostic value of pretreatment MRI in patients with prostate cancer treated with radiation therapy: a systematic review and meta-analysis. AJR Am J Roentgenol 214:597\u2013604. https:\/\/doi.org\/10.2214\/AJR.19.21836","journal-title":"AJR Am J Roentgenol"},{"key":"12397_CR11","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1007\/s00428-019-02574-0","volume":"475","author":"JG Kench","year":"2019","unstructured":"Kench JG, Judge M, Delahunt B et al (2019) Dataset for the reporting of prostate carcinoma in radical prostatectomy specimens: updated recommendations from the International Collaboration on Cancer Reporting. Virchows Arch 475:263\u2013277. https:\/\/doi.org\/10.1007\/s00428-019-02574-0","journal-title":"Virchows Arch"},{"key":"12397_CR12","doi-asserted-by":"publisher","first-page":"580","DOI":"10.1111\/his.12199","volume":"63","author":"D Danneman","year":"2013","unstructured":"Danneman D, Wiklund F, Wiklund NP, Egevad L (2013) Prognostic significance of histopathological features of extraprostatic extension of prostate cancer. Histopathology 63:580\u2013589. https:\/\/doi.org\/10.1111\/his.12199","journal-title":"Histopathology"},{"key":"12397_CR13","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-93340-3","volume":"11","author":"CK Park","year":"2021","unstructured":"Park CK, Chung YS, Choi YD et al (2021) Revisiting extraprostatic extension based on invasion depth and number for new algorithm for substaging of pT3a prostate cancer. Sci Rep 11:13952. https:\/\/doi.org\/10.1038\/s41598-021-93340-3","journal-title":"Sci Rep"},{"key":"12397_CR14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.clinimag.2019.08.007","volume":"59","author":"F Pesapane","year":"2020","unstructured":"Pesapane F, Standaert C, De Visschere P, Villeirs G (2020) T-staging of prostate cancer: identification of useful signs to standardize detection of posterolateral extraprostatic extension on prostate MRI. Clin Imaging 59:1\u20137. https:\/\/doi.org\/10.1016\/j.clinimag.2019.08.007","journal-title":"Clin Imaging"},{"key":"12397_CR15","doi-asserted-by":"publisher","first-page":"701","DOI":"10.1097\/PAS.0000000000002042","volume":"47","author":"H Samaratunga","year":"2023","unstructured":"Samaratunga H, Egevad L, Yaxley JW et al (2023) Clinicopathologic significance of anterior prostate cancer: comparison with posterior prostate cancer in the era of multiparametric magnetic resonance imaging. Am J Surg Pathol 47:701\u2013708. https:\/\/doi.org\/10.1097\/PAS.0000000000002042","journal-title":"Am J Surg Pathol"},{"key":"12397_CR16","doi-asserted-by":"publisher","DOI":"10.1259\/bjr.20190480","volume":"92","author":"F Zhang","year":"2019","unstructured":"Zhang F, Liu C-L, Chen Q et al (2019) Accuracy of multiparametric magnetic resonance imaging for detecting extracapsular extension in prostate cancer: a systematic review and meta-analysis. Br J Radiol 92:20190480. https:\/\/doi.org\/10.1259\/bjr.20190480","journal-title":"Br J Radiol"},{"key":"12397_CR17","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.eururo.2015.07.029","volume":"70","author":"M de Rooij","year":"2016","unstructured":"de Rooij M, Hamoen EHJ, Witjes JA et al (2016) Accuracy of magnetic resonance imaging for local staging of prostate cancer: a diagnostic meta-analysis. Eur Urol 70:233\u2013245. https:\/\/doi.org\/10.1016\/j.eururo.2015.07.029","journal-title":"Eur Urol"},{"key":"12397_CR18","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1038\/s41391-018-0116-z","volume":"22","author":"F J\u00e4derling","year":"2019","unstructured":"J\u00e4derling F, Akre O, Aly M et al (2019) Preoperative staging using magnetic resonance imaging and risk of positive surgical margins after prostate-cancer surgery. Prostate Cancer Prostatic Dis 22:391\u2013398. https:\/\/doi.org\/10.1038\/s41391-018-0116-z","journal-title":"Prostate Cancer Prostatic Dis"},{"key":"12397_CR19","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1016\/j.urology.2014.08.025","volume":"85","author":"MW Ball","year":"2015","unstructured":"Ball MW, Partin AW, Epstein JI (2015) Extent of extraprostatic extension independently influences biochemical recurrence-free survival: evidence for further pT3 subclassification. Urology 85:161\u2013164. https:\/\/doi.org\/10.1016\/j.urology.2014.08.025","journal-title":"Urology"},{"key":"12397_CR20","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1016\/j.ctro.2020.08.002","volume":"24","author":"A Gomez-Iturriaga","year":"2020","unstructured":"Gomez-Iturriaga A, B\u00fcchser D, Miguel IS et al (2020) MRI detected extaprostatic extension (EPE) in prostate cancer: do all T3a patients have the same outcomes? Clin Transl Radiat Oncol 24:135\u2013139. https:\/\/doi.org\/10.1016\/j.ctro.2020.08.002","journal-title":"Clin Transl Radiat Oncol"},{"key":"12397_CR21","doi-asserted-by":"publisher","first-page":"773","DOI":"10.2214\/AJR.23.29609","volume":"221","author":"KM Merriman","year":"2023","unstructured":"Merriman KM, Harmon SA, Belue MJ et al (2023) Comparison of MRI-based staging and pathologic staging for predicting biochemical recurrence of prostate cancer after radical prostatectomy. AJR Am J Roentgenol 221:773\u2013787. https:\/\/doi.org\/10.2214\/AJR.23.29609","journal-title":"AJR Am J Roentgenol"},{"key":"12397_CR22","doi-asserted-by":"publisher","first-page":"1811","DOI":"10.1007\/s10147-024-02621-0","volume":"29","author":"T Wakamiya","year":"2024","unstructured":"Wakamiya T, Kohjimoto Y, Yamashita S, Hara I (2024) Local extension findings on MRI compensate for the ability of pathological staging to predict oncological outcome. Int J Clin Oncol 29:1811\u20131816. https:\/\/doi.org\/10.1007\/s10147-024-02621-0","journal-title":"Int J Clin Oncol"},{"key":"12397_CR23","doi-asserted-by":"publisher","first-page":"448","DOI":"10.1016\/j.urolonc.2011.02.017","volume":"31","author":"R Renard-Penna","year":"2013","unstructured":"Renard-Penna R, Roupr\u00eat M, Comperat E et al (2013) Accuracy of high resolution (1.5 tesla) pelvic phased array magnetic resonance imaging (MRI) in staging prostate cancer in candidates for radical prostatectomy: results from a prospective study. Urol Oncol 31:448\u2013454. https:\/\/doi.org\/10.1016\/j.urolonc.2011.02.017","journal-title":"Urol Oncol"},{"key":"12397_CR24","doi-asserted-by":"publisher","first-page":"541","DOI":"10.1148\/radiol.2372041724","volume":"237","author":"JJ F\u00fctterer","year":"2005","unstructured":"F\u00fctterer JJ, Engelbrecht MR, Huisman HJ et al (2005) Staging prostate cancer with dynamic contrast-enhanced endorectal MR imaging prior to radical prostatectomy: experienced versus less experienced readers. Radiology 237:541\u2013549. https:\/\/doi.org\/10.1148\/radiol.2372041724","journal-title":"Radiology"},{"key":"12397_CR25","doi-asserted-by":"publisher","first-page":"995","DOI":"10.1007\/s00330-009-1625-x","volume":"20","author":"O Akin","year":"2010","unstructured":"Akin O, Riedl CC, Ishill NM et al (2010) Interactive dedicated training curriculum improves accuracy in the interpretation of MR imaging of prostate cancer. Eur Radiol 20:995\u20131002. https:\/\/doi.org\/10.1007\/s00330-009-1625-x","journal-title":"Eur Radiol"},{"key":"12397_CR26","doi-asserted-by":"publisher","unstructured":"de Rooij M, Allen C, Twilt JJ et al (2024) PI-QUAL version 2: an update of a standardised scoring system for the assessment of image quality of prostate MRI. Eur Radiol. https:\/\/doi.org\/10.1007\/s00330-024-10795-4","DOI":"10.1007\/s00330-024-10795-4"},{"key":"12397_CR27","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.euros.2022.11.013","volume":"47","author":"O Windisch","year":"2023","unstructured":"Windisch O, Benamran D, Dariane C et al (2023) Role of the prostate imaging quality PI-QUAL score for prostate magnetic resonance image quality in pathological upstaging after radical prostatectomy: a multicentre European study. Eur Urol Open Sci 47:94\u2013101. https:\/\/doi.org\/10.1016\/j.euros.2022.11.013","journal-title":"Eur Urol Open Sci"},{"key":"12397_CR28","doi-asserted-by":"publisher","unstructured":"Knott E, Bullen J, Harris R et al (2025) Improving prostate MRI quality and its diagnostic impact: a prospective quality improvement initiative. Abdom Radiol. https:\/\/doi.org\/10.1007\/s00261-025-05011-w","DOI":"10.1007\/s00261-025-05011-w"},{"key":"12397_CR29","doi-asserted-by":"publisher","first-page":"2891","DOI":"10.1007\/s00261-024-04468-5","volume":"49","author":"Y Lin","year":"2024","unstructured":"Lin Y, Belue MJ, Yilmaz EC et al (2024) Deep learning-based image quality assessment: impact on detection accuracy of prostate cancer extraprostatic extension on MRI. Abdom Radiol 49:2891\u20132901. https:\/\/doi.org\/10.1007\/s00261-024-04468-5","journal-title":"Abdom Radiol"}],"container-title":["European Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-026-12397-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00330-026-12397-8","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-026-12397-8.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T10:18:18Z","timestamp":1781864298000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00330-026-12397-8"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,20]]},"references-count":29,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7]]}},"alternative-id":["12397"],"URL":"https:\/\/doi.org\/10.1007\/s00330-026-12397-8","relation":{},"ISSN":["1432-1084"],"issn-type":[{"value":"1432-1084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,20]]},"assertion":[{"value":"15 October 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 December 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"18 December 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 February 2026","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The scientific guarantor of this publication is Ivo G. Schoots.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor"}},{"value":"The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"No complex statistical methods were necessary for this paper.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was not required for this study.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was not required.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Not applicable.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}