Trending Clinical Topic: Manography

Ryan Syrek

Disclosures

August 16, 2019

Each week, we identify one top search term, speculate as to what caused its popularity, and provide an infographic on a related condition. If you have thoughts about what's trending and why, feel free to share them with us on Twitter or Facebook!

A proposed new diagnostic approach, support for an older prognostic test, and a newly approved medication helped make "manography" this week's top trending clinical topic. Jelle Barenstz, MD, PhD, of Radboud University Medical Center in Nijmegen, the Netherlands, recently suggested that a fast, biparametric MRI technique may be able to replace painful biopsy testing in assessing prostate cancer. He proposed the term "manography" for the approach, which could be used as the first step in the workup of patients with elevated prostate-specific antigen (PSA) levels. This term is suggested because MRI of the prostate may one day become as routine as mammography screening for breast cancer in women.

Although such imaging may be the future of prostate cancer workup, a recent study concluded that the digital rectal exam (DRE) remains an important and clinically relevant prognostic investigation. The observational, retrospective study found that clinical stage classification via DRE is significantly prognostic in terms of overall survival among men with high-risk localized disease. The authors flatly state that "the findings reaffirm that prostate cancer clinicians should be using DRE."

Beyond diagnosis and workup, the US Food and Drug Administration (FDA) recently approved darolutamide for use in patients with nonmetastatic castration-resistant prostate cancer. This approval came 3 months ahead of the target FDA action date as part of a priority review. This was based on results from the phase 3 ARAMIS trial, which found a significant improvement in the primary endpoint of metastasis-free survival. The risk of metastasis or death from any cause was reduced by 59%. Although "manography" may not be a well-known term yet, interest in both that study and issues related to the condition for which it is indicated helped make it this week's top trending clinical topic.

Read more about prostate cancer.

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