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Using MRI scans prior to prostate biopsies could help around a quarter of men avoid biopsy

Giving men with suspected prostate cancer an MRI scan could improve diagnosis and save those who do not have aggressive cancers from having an unnecessary biopsy, according to a new study.

20 January 2017

The Prostate MRI Imaging Study (PROMIS) estimates that adding the extra test could help one in four (27%) men avoid an unnecessary biopsy and reduce the number of men who are over-diagnosed – diagnosed with a cancer that does not go on to cause any harm during their lifetime – by 5%.

Typically, men undergo a biopsy of their prostate if they experience symptoms of prostate cancer or have a prostate specific antigen (PSA) test showing high levels of the PSA protein in their blood. Each year, over 100,000 prostate biopsies are carried out in the UK and one million are conducted in Europe. However, the PSA test is not always accurate, which means that many men undergo unnecessary biopsies.

The study was funded by the National Institute for Health Research, the Biomedical Research Centre (BRC) at The Royal Marsden and The Institute of Cancer Research, and the University College London Hospitals BRC.

Professor Ros Eeles, Professor of Prostate Cancer Genetics at the ICR, and Consultant Clinical Oncologist at The Royal Marsden, said: “This is a very important study that compares our current standard practice for men who have raised levels of PSA in the blood – which requires them to undergo an invasive prostate biopsy – with a new method, using MRI as an added step to diagnose the disease.

“We are searching for better ways to diagnose prostate cancer, the commonest cancer in men in the UK, since PSA alone is an imperfect test. This study provides ground breaking data that the addition of a multi parametric MRI can be used in the diagnostic pathway after PSA to better predict who would most benefit from prostate biopsy. An economic evaluation will now be needed to demonstrate if this method is cost-effective, and should be taken up as standard of care, since internationally MRI prior to prostate biopsy is not universally practised.”

To read The Lancet article, please click here.