MRI scanning can help spare men from unnecessary biopsies when prostate cancer is suspected, British researchers report today.
The test could spare 27% of patients from having a biopsy and reduce the number of over-diagnosed patients by 5%, researchers report in The Lancet.
The findings come from a study of 576 men with suspected prostate cancer in 11 UK hospitals.
They were given an MP-MRI scan followed by two types of biopsy, including a template prostate mapping biopsy and the standard ultra-sound guided biopsy.
The scan correctly diagnosed 93% of men with aggressive cancers – but only 48% of these were identified by the ultra-sound guided biopsy.
Some 89% of those who had a negative MRI result had no cancer or a harmless cancer.
The biopsies triggered 44 serious adverse events.
Researcher Dr Hashim Ahmed, from University College, London, UK, said: "Our results show that MP-MRI should be used before biopsy. Our study found that using the two tests could reduce over-diagnosis of harmless cancers by 5%, prevent one in four men having an unnecessary biopsy, and improve the detection of aggressive cancers from 48% to 93.
"While combining the two tests gives better results than biopsy alone, this is still not 100% accurate so it would be important that men would still be monitored after their MP-MRI scan.
"Biopsies will still be needed if an MP-MRI scan shows suspected cancer too, but the scan could help to guide the biopsy so that fewer and better biopsies are taken."
Dr Neha Issar-Brown, from the Medical Research Council, which backed the research, said: "Not only will this enable one in four men to avoid the stress of a potentially unnecessary procedure and its side effects but also the emotional toll of a misdiagnosis.
“We also need more information about overall cost-effectiveness of this approach and work to ensure there are enough MRI scanners and appropriately trained urologists and radiologists to implement this approach more widely in the NHS.”
Diagnostic accuracy of multi-parametric MRI and TRUS biopsy in prostate cancer (PROMIS): a paired validating confirmatory study Lancet 20 January 2017 [abstract]
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