International Agreement Reached on New Standard for the Evaluation of MRI Scans for Prostate Cancer

The European Association of Urology (EAU; Arnhem, The Netherlands) has published new standards for the acquisition and reporting of Magnetic Resonance Imaging (MRI) scans to confirm a diagnosis of prostate cancer.

The Prostate Imaging and Reporting and Data System (PI-RADS) system standard was agreed between international radiological bodies and was published in the European Association of Urology’s peer-reviewed journal, European Urology. The standard enables radiologists to identify up to 13% more deadly prostate tumors, and could reduce over-diagnosis of insignificant cancers by nearly 89% compared to current procedures. Nearly 80% of men in Europe have a microscopic cancer at age 80, and nearly 50% at age 55.

A new MRI imaging technique, called multiparametric prostate Magnetic Resonance Imaging (mpMRI) has been in use and refined in the past few decades, but image acquisition and reporting guidelines are also essential for identifying prostate cancer. A previous version of the PI-RADS system standard already improved the diagnosis of intermediate- to high-grade cancers in clinical trials. The new version, PI-RADS version 2 updates, provides detailed instructions, and simplifies the acquisition, interpretation, and reporting of mpMRI scans.

Many studies have confirmed that mpMRI can prevent unnecessary biopsies, and improves the ability of a radiologist to identify clinically significant cancers when biopsies are made. MRI-targeted biopsies using mpMRI have been shown to provide better results than current ultrasound guided biopsy protocols.

Prof. Hendrik Van Poppel, University of Leuven, Belgium, from the European Association of Urology, said, "PSA screening decreases prostate cancer mortality but exposes to over-diagnosis and over-treatment. mpMRI will not only simplify this screening, it will also play an important role in the follow-up of patients under active surveillance. It should be the first exam a patient at risk of significant prostate cancer should have. As for the costs of mpMRI, these should be weighed against the saving of costs of unnecessary biopsies, coping with complications and possible unnecessary treatments".

Related Links:
European Association of Urology