The benefits of preoperative prostate MRI are clear, so why isn't every man getting one?
Preoperative prostate MRI exams improve surgical outcomes overall but remain widely underutilized in areas where MRI access is readily available.
Prostate MRI exams offer tumor characteristics in great detail and can be a valuable tool for surgical planning. Although its use has grown over the last decade or so, the imaging modality is still not considered integral to preoperative routines for many prostate cancer patients.
This was revealed recently in a study published in the Journal of Urology, which examined more than 19,000 patients who had undergone prostatectomy after a cancer diagnosis to investigate the utilization of preoperative prostate MRI. The data were derived between 2003 and 2016 from 72 hospital referral regions. Although its preoperative use increased substantially during that time—from 2.9% to 28.2% to be exact—the modality remained underutilized in certain regions and among specific populations in the United States.
In the study, the benefits of the exam were clear—prostate MRI exams were found to lower the odds of positive surgical margins as well as the likelihood that a patient would need a blood transfusion at 30 and 90 days post-op. But not every case included in the study felt the impact of these benefits—compared to 10.2% of white men, just 6.1% of black patients underwent a preoperative MRI for surgical planning.
“While MRI is a tool that is changing the diagnosis and treatment of prostate cancer, our work shows that the chance of getting a preoperative prostate MRI varies significantly depending on where you happen to be living, what race you are, and on what year you were diagnosed,” corresponding author Alexander Cole, MD, of the Brigham’s Division of Urology, and co-authors shared.
In addition to race, marital status and geographic location were both found to be associated with preoperative prostate MRI completion, with married men and men who lived within the same region as the hospital where they were treated undergoing the exam more frequently than their peers. Other potential factors influencing this could be related to cost and health literacy, the authors indicated.
Though the increasing utilization of the exam will inevitably improve cancer care for many men, Cole suggested there is still work to do:
We are trying to connect with community leaders to bridge the gap between underserved communities and high-quality services. By attacking some of the variability in treatment highlighted by our study, we could potentially improve prostate cancer outcomes overall.”
View the study abstract here.
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In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She joined Innovate Healthcare in 2021 and has since put her unique expertise to use in her editorial role with Health Imaging.