Prostate biopsies are one of the only ways to predict an aggressive cancer, but they are painful, inconvenient and somewhat inaccurate. A report from Dr. Ahmed Haddad, fellow at the University of Texas Southwestern Medical Center in Dallas, presented at the American Urological Association annual meeting showed that multiparametric MRI scans following a suggestive PSA test or digital rectal exam could reduce the need for a biopsy while still providing an accurate prediction for prostate cancer patients.
In his report, Dr. Haddad and his colleagues found a 73 percent reduction in the need for a biopsy when using the multiparametric MRI scan, identifying fewer potential cancers and requiring fewer biopsies as a result. Interestingly, the cost for MPMRI is slightly lower than at transrectal ultrasoundguided biopsy. However, the study also found that the MPMRI missed a few cancers, identifying 16 cancers for every 100 men compared to 20.4 cancers out of 100 men for the biopsy.
In deciding the best way to treat prostate cancer, doctors must weigh the risks of treatment, including its affect on quality of life for patients, against the potential benefit and lifesaving capabilities of treatment. Because so many prostate tumors do not behave like typical cancers, and do not pose a risk to the patient’s life,urologists are constantly looking for ways to better predict the outcome of a particular cancer. This particular study showed the potential for the use of MRI technology to identify cancers even without the use of a biopsy.
According to Dr. Haddad, the study was successful in determining that MPMRI was able to reduce the number of prostate biopsies for patients in a cost equivalent way. However, he did state that further study was needed to determine the clinical significance of the cancers missed by the MRI. As an initial study, it shows promise, and further study in the future will help determine whether this can be an effective diagnostic choice.