Division of Surgery and Interventional Science, University College London, London, UK.
Overdiagnosis is arguably the greatest challenge in the management of men with prostate cancer. Multi-parametric (mp)-MRI prior to prostate biopsy may have a role in ruling-in and ruling-out clinically significant disease.
114 consecutive men at risk of prostate cancer with previous biopsy underwent mp-MRI prior to transrectal ultrasound (TRUS)-guided biopsies. Standard systematic biopsies were carried out with targeting to suspicious areas.
59.6% had cancer detected by TRUS-guided biopsy. Mean age was 63.6 years (SD 9.0). If men had not been biopsied because of a negative mp-MRI, 21% (24/114) with no cancer and 5% (6/114) with clinically insignificant cancer could have avoided a biopsy. However, 4% (4/114) would have been advised to defer a biopsy that demonstrated the presence of clinically significant cancer.
mp-MRI may have a role in ruling-in and ruling-out clinically significant prostate cancer in men at risk prior to biopsy.
Rouse P, Shaw G, Ahmed HU, Freeman A, Allen C, Emberton M. Are you the author?
Reference: Urol Int. 2011 Jun 22. Epub ahead of print.