New study shows benefit of MRI for Prostate Cancer diagnosis
MEDIA RELEASE | 20 March 2018
A study published in the New England Journal of Medicine shows that the use of MRI (multi-parametric magnetic resonance imaging) can improve the diagnosis of prostate cancer by enhancing the detection of clinically significant cancer that would benefit from treatment, while also ruling out insignificant cancers following investigation of an abnormal PSA (prostate-specific antigen).
The PRECISION study 1) was a multi centre, randomized trial of 500 men with elevated PSA who had not undergone biopsy. It found that the use of risk assessment with MRI before biopsy and MRI-targeted biopsy was more effective than standard transrectal ultrasonography-guided biopsy in men at clinical risk for prostate cancer who had not undergone biopsy previously.
“This study confirms the benefit of MRI technology in improving the PSA testing pathway to detect prostate cancer,” says Professor Shomik Sengupta, Urological Society of Australia and New Zealand’s UroOncology Advisory Group Leader.
“While it is the best available test, the PSA blood test is not a conclusive test as to whether a man has prostate cancer or not – it is merely a flag that prostate cancer may be present and this is usually confirmed by subsequent biopsies which are invasive and in a small minority of cases can have side effects or complications. The PSA test is also criticized for detecting low-risk or indolent prostate cancers that may not have caused any problems.
“What this study confirms is the value of the use of MRI following an elevated PSA to help decide whether a biopsy is necessary or not as well as to improve the diagnostic process to pick up significant cancers and avoid diagnosing indolent cancers.
“If we can safely reduce the number of biopsies, not only would this eliminate unnecessary discomfort and complications, but would also represent a significant cost saving, since the cost of a biopsy is substantially higher than a MRI scan” says Professor Sengupta.
“Additionally the use of MRI guided biopsies in those men who are identified at risk allows for more accurate diagnosis and appropriate management of prostate cancer. Our aim is always to make sure we identify those men who would benefit from treatment while minimizing the identification of men with clinically insignificant cancer to prevent overtreatment.”
While Australia is well ahead of many other countries in terms of usage and access to this technology it still has limitations of availability and there is currently no Medicare rebate available.
“We expect this important study will add to the body of evidence currently under review as the Government decides whether to reimburse this technology for prostate cancer diagnosis for men who need it, says Professor Sengupta.
“While the benefits of this technology are exciting it is important to qualify this by recognizing that like any technology the benefits are only as good as the skill of the operator.
“Ensuring the use of MRIs in this setting are conducted by specialists with appropriate experience and expertise to ensure prostate MRIs are reliable is of paramount importance.”
1) http://www.nejm.org/doi/full/10.1056/NEJMoa1801993
Media enquiries or to arrange an interview with Professor Shomik Sengupta:
Please email Edwina Gatenby or call +61 402 130 254