Preoperative prostate MRI exams can offer added value in predicting biochemical recurrence (BCR) of prostate cancer and often perform comparably to post-surgical pathologic staging. 

That’s according to new data published in the American Journal of Roentgenology, comparing the utility of pre-surgical staging information from MRI and post-surgical staging information from radical prostatectomy (RP) pathology in predicting cancer recurrence. A group of experts involved in the study looked at the cases of 604 patients with prostate cancer who underwent both preoperative MRI and postoperative pathology and found that the BCR-free survival rates were comparable using each staging method—a finding that could improve preoperative assessments for prostate cancer patients, the group suggested. 

“MRI staging can preoperatively identify patients at high BCR risk, helping to inform early clinical decision making,” corresponding author Baris Turkbey, MD, with the Molecular Imaging Branch of the National Cancer Institute in Bethesda, Maryland, and colleagues noted.

For their study, the group had a genitourinary radiologist retrospectively analyze the cases of patients who underwent prostate MRI before RP from June 2007 to December 2018. Exams were assessed specifically for extraprostatic extension (EPE) and seminal vesicle invasion (SVI); those findings were then compared to outcomes to better understand how they might relate to BCR. 

When compared to the patient’s postoperative pathology results, the presence and/or absence of both EPE and SVI on imaging provided similar value in predicting cancer recurrence, ranging by just a few percentage points in multiple metrics. 

Currently, BCR prediction is based largely on results from postoperative RP specimens but given the similarities in accuracy between pathology results and preoperative imaging, MRI could have a greater role in risk assessments in the future, the group suggested. 

The study abstract is available here.