A STUDY conducted by researchers in Berlin, Germany has found that using MRI as a first step in prostate cancer detection is safe and effective for at least three years. This study has shown that patients with normal MRI findings can safely avoid immediate biopsies and instead undergo regular monitoring, reducing unnecessary procedures and associated risks.
Traditionally, prostate cancer detection relies on blood tests for prostate-specific antigen (PSA) levels, followed by systematic biopsies if PSA levels are elevated. However, this conventional approach often leads to overdiagnosis of slow-growing cancers and misses aggressive forms. Systematic biopsies are also associated with discomfort, infection risks, and false positives due to non-cancerous conditions.
To address these issues, the team investigated whether MRI could reliably guide biopsy decisions. The authors explained that they “wanted to determine if men with suspected prostate cancer but normal MRI findings could safely skip biopsies and instead undergo regular follow-ups.”
The study included nearly 600 men with suspected prostate cancer who underwent multiparametric MRI (mpMRI), a technique that evaluates various tissue-specific parameters such as blood flow and signal intensity. Biopsies were performed only when MRI scans revealed abnormalities. Patients with normal MRI results received regular urological monitoring over three years.
Findings showed that 96% of patients with normal MRI results did not develop aggressive prostate cancer within three years, and only 4% showed signs of cancer during follow-ups. “While no method is foolproof, regular monitoring ensures any potential cancer is detected early enough for effective treatment,” the research team explained.
The study underscores the importance of high-quality imaging and expert interpretation, alongside clear guidelines for follow-ups. Already recommended by the European Association of Urology, MRI before biopsy may now gain further acceptance, potentially transforming prostate cancer diagnostics globally. Researchers hope their findings will pave the way for personalised care, sparing many men unnecessary procedures while ensuring timely detection of serious cancers.
Victoria Antoniou, EMJ
Reference
Hamm CA et al. Oncological safety of MRI-informed biopsy decision-making in men with suspected prostate cancer. 2024;DOI:10.1001/jamaoncol.2024.5497.
