Steady uptick in MRI-guided biopsies hasn’t helped all prostate cancer patients equally
Radiology has experienced a dramatic uptick in pre-biopsy MRI utilization among patients with potential prostate cancer over recent years. But the increase hasn’t extended to all men.
That’s what urologists, imaging providers and policy experts found after analyzing more than 82,000 patients who underwent prostate biopsy between 2008 and 2015. At the close of that seven-year time period, nearly 1 in 10 who had never received a biopsy and 1 in 4 who had a past negative result were getting MRI scans before a cancer diagnosis.
But over that same stretch, African American men were almost half as likely to receive imaging compared to their white peers, researchers reported June 23 in the American Journal of Roentgenology. They also found geographic disparities in MRI utilization favoring those living in the Northeast.
It goes to show that healthcare advancements don’t always correlate to better care for all, Christopher D. Gaffney, MD, a urologist with New York–Presbyterian Hospital, and colleagues noted.
“Overall, these results suggest that the adoption of new expensive technologies can exacerbate discrepancies in care,” Gaffney and co-authors added. “Efforts to ensure that access to the benefits of MRI are equitably distributed should be a priority.”
For their study, Gaffney et al. pored over a Medicare-linked database of men who had an MRI scan within six months of their cancer diagnosis. That included 78,253 who were biopsy naive and 4,230 with a known prior negative biopsy.
Among this particular patient population, overall MRI use increased from 0.5% to 9.2% between 2008 and 2015. In addition to the disparity seen in Black men, people living in the Northeast were more likely to undergo MRI than residents of the Midwest, West and South.
This bump in imaging did occur prior to research demonstrating the value of prostate MRI as well as American Urological Association guidelines encouraging its use. Given this, Gaffney and co-authors only see MRI use increasing.
“With the subsequent release of evidence in favor of MRI-targeted biopsy, we expect continued increases in the utilization of MRI before prostate biopsy,” the researchers concluded. “Care must be taken such that underserved populations may benefit from new technologies such as MRI as utilization becomes more widespread.”
Read the full study here.
Matt joined Chicago’s TriMed team in 2018 covering all areas of health imaging after two years reporting on the hospital field. He holds a bachelor’s in English from UIC, and enjoys a good cup of coffee and an interesting documentary.