An expert panel of urologists and radiologists from the American Urological Association (AUA) and the Society of Abdominal Radiology (SAR) has issued a set of consensus statements indicating that MRI (magnetic resonance imaging)-targeted biopsies could be used to monitor patients with negative biopsy for prostate cancer.
The consensus statements were published in the Journal of Urology and include detailed literature upon which the panel’s recommendations are based.
Prostate MRI is a technology that helps in the identification of patients with previous negative biopsies who might require repeat biopsies. The MRI works by identifying areas of interest to target and direct biopsies, as well as to help direct biopsies to these areas that need image guidance.
The debate around the issue questions if these patients should be monitored at all, and if they should, then how should health care providers deal with the concerns about over-detection, over-treatment and under-detection due to sampling errors in biopsies.
In answer to the questions around the issue, the panel recommends that prostate MRI and MRI-targeted biopsies be used for any patients in whom prostate cancer is suspected, even if they have had a negative biopsy, or for those considering a possible repeat biopsy.
A decision to perform an MRI also should take into account the results of any other biomarkers and he cost of the examination, the panel recommended.
“The panel recognized a role for prostate MRI and MRI-targeted biopsy to increase the detection of clinically significant prostate cancer in the repeat biopsy setting. It also explored challenges facing the wider clinical implementation of MRI targeted biopsy at this time,” Andrew Rosenkrantz, MD, associate professor in the Departments of Radiology and Urology at NYU Langone Medical Center, said in a press release.
The authors claim that an increasing body of literature is demonstrating the value of MRI-targeted biopsy in the repeat biopsy setting. However, these techniques are still very recent and there is a lack of standardization of image quality and individual radiologists’ interpretation abilities.
Moreover, key recommendations of the consensus statements include adherence to Prostate Imaging Reporting and Data System (PI-RADS) Version 2.0, stricter quality standards, as well as considering the need for close clinical and lab surveillance when prescribing repeat biopsy based on MRI findings.
The idea behind the consensus statement is that it can help change how prostate cancer is diagnosed in the U.S. by giving patients more reliable, targeted biopsies, with more accurate risk assessment and improved treatment options.
“The consensus statement was developed in a collaborative fashion by a panel of both urologists and radiologists, thus integrating the two groups’ experiences, expertise, and insights to generate as clinically relevant and practical a paradigm as possible,” added Rosenkrantz.