Using MRI to Achieve Early Detection of Prostate Cancer

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Prostate cancer is the most common solid tumor in American men. The prostate-specific antigen (PSA) test is often used to screen men for prostate cancer, however there is controversy around the poor sensitivity and specificity of the PSA test. It can lead to unnecessary biopsies and the overtreatment of low-grade cancers.  

Recently, magnetic resonance imaging (MRI) has been proposed as a way to achieve early detection of high-grade cancer in a minimally invasive way. Recent research, recognized as article of the week by the BJU International, was undertaken to determine the best way to use MRI and targeted MRI/ultrasonography fusion biopsy and whether it can be cost-effective. 

The results show that incorporating MRI into prostate cancer screening can be cost-effective.  

Previous decision analyses evaluated one potential diagnostic pathway compared to the standard of care. However, several possible ways to incorporate MRI and targeted MRI/ultrasonography fusion biopsy exist, and it was unclear which approach was best. Our study was the first to evaluate eight MRI-based clinical pathways in addition to standard of care and determine which approach was most cost-effective.  

The use of MRI could reduce unnecessary biopsies, which cause stress and pain for the patient and could potentially result in hospitalization due to sepsis. Additionally, since MRI is more sensitive to intermediate- and high-grade cancers than low-grade cancers, the use of MRI in the screening of men for prostate cancer could reduce overtreatment by specifically detecting higher grade cancers.  

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Cost‐effectiveness of magnetic resonance imaging and targeted fusion biopsy for early detection of prostate cancer. Barnett CL, Davenport MS, Montgomery JS, Wei JT, Montie JE, Denton BT. BJU Int. 2018 Mar 8. 

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