A strategy that combines PSA with MRI exams can improve the detection of prostate cancer and decrease instances of unnecessary biopsies.
In a cohort of more than 800 patients with suspected prostate cancer who underwent either PSA, MRI or PSA with MRI screening prior to biopsy, the strategy that combined the two tests meaningfully improved specificity and positive predictive value in detecting clinically significant cancer (CSC) compared to PSA alone.
This new work was published recently in Academic Radiology. There, corresponding author of the study U-Syn Ha MD, PhD, from the Department of Urology with the College of Medicine at The Catholic University of Korea, and colleagues explained that their strategy could help patients avoid unnecessary biopsy by restricting the invasive procedure to those who have both positive PSA and MRI screenings.
“About half of patients could avoid biopsy without compromising detection of CSC using prebiopsy MRI,” the authors shared.
Patients involved in the study had follow-up information available for two years following their initial screenings. Out of 881 participants, 220 were diagnosed with prostate cancer and CSC was detected in 162 patients. The protocol was found to be beneficial in patients with a PSA level not only in the gray zone, but also above the gray zone (10 ng/mL ≤ PSA ≤ 20 ng/mL).
The authors noted that while the protocol increased specificity, PPV and NPV, it did result in a lower sensitivity compared to PSA alone (0.679 vs 0.938).
Despite the decrease in sensitivity, the researchers maintained that their findings were “consistently beneficial” in avoiding unnecessary biopsy.
To learn more about the study, click here.
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.