Introducing MRI into clinical practice helps reduce the rate of unnecessary prostate biopsies

Introducing MRI into regular clinical practice can help reduce the rate of unnecessary prostate biopsies, among other benefits, according to a new analysis published in JAMA Network Open.

Various guidelines have recommended magnetic resonance imaging to help inform biopsy decision-making, while randomized clinical trials also have proven its utility. Swedish researchers recently explored whether this practice can prove useful in real-world clinical settings, publishing their work Aug. 22.

The retrospective, population-based study included nearly 24,000 men who underwent PSA testing in the Jönköping Region of Sweden between 2011 and 2020. They discovered that, when the use of MRI increased, providers performed fewer biopsies (odds ratio of 0.84). The chances of detecting low-grade cancers also decreased (OR, 0.47), while discovery of medium-grade or higher cases increased (OR, 1.24).  

“We argue that the results could be replicated elsewhere if guidelines are followed and the urologist and MRI radiologist are dedicated,” David Robinson, PhD, with the Department of Radiology at Highland Hospital in Eksjö, Sweden, and co-authors noted. “To the best of our knowledge, this is the first study on the effect of the introduction of MRI-targeted biopsies on biopsy frequency and biopsy grading in clinical practice.”

The study incorporated all men who received a prostate-specific antigen test during the study period and excluded those with known cancer as of Nov. 1, 2015. Robinson et al. said their findings appear in line with those produced in previous randomized clinical trials of men with clinical suspicion of prostate cancer.

“Our results support that all men with PSA between 3 and 20 ng/mL should undergo MRI before biopsy,” they concluded. “These results need to be replicated and expanded in larger cohorts in clinical practice to study pertinent subgroups.”

Read further details in JAMA at the link below.