Can MRI Improve Detection of Clinically Significant Prostate Cancer?

By: Joshua D. Madera, MD
Posted: Monday, September 18, 2023

MRI has been used as an adjunct to detect clinically significant cancer in patients with elevated prostate-specific antigen (PSA) levels, although it has not been used routinely as an independent screening tool for prostate cancer. However, a recent study published in BMJ Oncology supports the use of prostate MRI as a primary screening tool for prostate cancer independent of PSA levels. Additional investigative efforts are warranted to determine its role in larger prostate cancer screening studies, explained Caroline M. Moore, MD, of the University College London, and colleagues.

A total of 303 men between the ages of 50 and 75 were randomly recruited from eight different general practices across the United Kingdom. All patients were screened for prostate cancer according to PSA levels and prostate MRI. Patients who had evidence of prostate cancer on MRI or a PSA density of 0.12 ng/mL² or greater were advised to forgo additional evaluation using the National Health Service (NHS) prostate cancer assessment.

The study authors reported a positive screening MRI of the prostate in approximately 16% of male patients. Comparatively, 5% of male patients had a clinically significant elevated PSA density alone. These patients subsequently were evaluated with the NHS prostate cancer assessment, which revealed a diagnosis of clinically significant cancer in 9.6% of men. Moreover, 1% of patients were diagnosed with clinically insignificant cancer.

“Future research would need to assess the feasibility of a community-based MRI delivery program, with use of a mobile MRI scanner, such as those used in some breast cancer screening programs,” suggested Dr. Moore and her colleagues.

Disclosure: For full disclosures of the study authors, visit bmjoncology.bmj.com.

BMJ Oncology

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