New diagnostic frontiers for MR imaging

por Lauren Dubinsky, Senior Reporter | November 11, 2019
From the November 2019 issue of HealthCare Business News magazine

MR’s role in prostate cancer detection
Another indication where MR is showing increased potential is in the detection of prostate cancer.

Dr. Richard Bryant
“The use of pre-biopsy MR in clinical pathways to detect prostate cancer is a very topical area of current active research, with recent high-impact publications demonstrating its benefit, along with its recent recommendation in several national clinical guidelines,” said Dr. Richard Bryant, associate professor of urology at the Nuffield Department of Surgical Sciences at the University of Oxford and the department of urology at Churchill Hospital of Oxford University Hospitals NHS Foundation Trust.
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Bryant and his team conducted a systematic review of seven randomized controlled trials that included a total of 2,582 patients. These trials demonstrated that pre-biopsy MR combined with targeted biopsy may improve the detection of clinically significant prostate cancer and reduce biopsy costs per procedure.

In a conventional ultrasound-guided needle biopsy, the procedures are performed without any specific pre-biopsy imaging. According to Bryant, this approach focused on an area where only 70 percent of all prostate cancers develop, which could lead to undertreatment.

When asked about the cost of pre-biopsy MR, Bryant explained that the cost “has been falling in recent years and as this imaging becomes more widespread in a larger number of centers across the world, the cost per scan is likely to drop still further.”

Furthermore, the cost of the MR imaging may be offset by savings that come from fewer biopsy procedures and a reduction in the detection of low-risk low-volume prostate cancer. Many of those men may avoid undergoing a biopsy if their multi-parametric MR shows no cause for concern.

But for those that do undergo a biopsy, MR may also be a vital asset for guidance purposes. A University of California, Los Angeles (UCLA) study from June 2019 found that combining MR and ultrasound to guide prostate cancer biopsies may detect up to 33 percent more tumors.

Ultrasound shows the location of the tumors in the prostate gland and MR can locate specific lesions enabling physicians to only biopsy tissue samples from those areas.

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