Multiparametric MRI improves prostate cancer detection

  • Donato P & al.
  • World J Urol
  • 4 May 2019

  • International Clinical Digest
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Takeaway

  • Multiparametric magnetic resonance imaging (mpMRI) offers a cost-effective triage solution that improves diagnosis of clinically significant (cs) prostate cancer (PCa) while reducing unnecessary biopsies and overtreatment of insignificant PCa.

Why this matters

  • The traditional diagnostic approach, systematic transrectal ultrasound-guided prostate biopsy, is invasive, has a false-negative rate of >40%, and leads to overdiagnosis of low-grade, insignificant PCa.

Study design

  • Researchers analyzed the health records of 653 consecutive patients with suspected PCa who underwent mpMRI at a large public tertiary referral training hospital:
    • Age: median, 65 (interquartile range, 58-70) years.
    • PSA: median, 6.8 (interquartile range, 4.6-9.6) ng/mL.
    • Prostate volume: median, 52 (interquartile range, 45-75) mL.
    • PSA density: median, 0.12 (interquartile range, 0.08–0.20).
  • Funding: None.

Key results

  • PCa was diagnosed in 240 patients (69.8%).
  • csPCa was diagnosed in 208 patients (60.5%).
  • Higher rates of csPCa were observed for higher Prostate Imaging Reporting and Data System scores.
  • mpMRI resulted in a 47.3% biopsy avoidance rate.

Limitations

  • The study was retrospective and subject to patient selection bias.