MRI reduces over-diagnosis of prostate cancer

Prostate cancer is fourth most commonly diagnosed cancer worldwide, but there are major geographical differences in incidence. In Sweden, which has among the highest reported prostate cancer incidences globally, prostate cancer constitutes the most common cancer diagnosis. An estimated 1 in 8 Swedish men is expected to develop prostate cancer before the age of 85 (Cancer i siffror 2013; Cancerfonden). According to diagnostic procedures used clinically today, a prostate cancer examination is initiated after physical symptoms and/or a raised prostate-specific antigen (PSA)-test. The man is then subjected to ultrasound-guided transrectal guided biopsies, a painful procedure that involves taking up to 30 needle biopsies of the prostate gland through the rectum. An Australian clinical trial published in European Urology now concludes that MRI significantly improves diagnosis of prostate cancer and reduces the over-diagnosis of the disease, thereby avoiding side-effects and suffering associated with unnecessary treatment. In the study performed at Brisbane’s Wesley Hospital, 223 patients with raised PSA-values underwent both the standard ultrasound-guided biopsy procedure and a so called multi-parameter MRI method. In men with suspicious lesions the MRI-procedure was followed by an MRI-guided biopsy procedure taking only two samples in indicated areas. The results showed that the MRI-method for prostate cancer detection was superior in both sensitivity and specificity. The number of men needing prostate biopsies at all was reduced by 51 %. Link to publication