March 2026

A major international clinical trial published in JAMA has demonstrated that biparametric MRI is just as effective as the current gold standard for detecting clinically significant prostate cancer — a finding with far-reaching implications for patients and healthcare systems worldwide.

The PRIME trial, conducted across 22 centres in 12 countries and involving 490 men, compared biparametric MRI (bpMRI) — which omits the gadolinium contrast injection — with the established multiparametric MRI (mpMRI). The results were striking in their consistency: both methods identified clinically significant cancer in virtually identical proportions of patients (29.2% vs. 29.6%), confirming that biparametric MRI is noninferior to the longer standard.

What does this mean in practice? Biparametric MRI reduces scan time from 30–40 minutes to just 15–20 minutes, eliminates the need for a contrast injection and its associated risks, and removes the requirement for a physician to be present during scanning. It also avoids gadolinium — a contrast agent known to deposit in the brain, bone, and liver, and to contaminate the environment.

The study's authors conclude that biparametric MRI, provided image quality meets required standards and experienced radiologists are involved, performs very similarly to multiparametric MRI for cancer detection, staging, and treatment planning — providing level-1 evidence that it could become the new first-line diagnostic standard for men with suspected prostate cancer. 

With approximately four million prostate MRI scans performed globally every year, the implications are profound. In some healthcare settings, fewer than one in three men currently have access to this test — despite its critical role in smarter prostate cancer diagnosis. As the Lancet Commission has highlighted, prostate cancer cases are set to double over the next 20 years, making access to imaging an ever more urgent global challenge. 

As lead investigator Prof. Veeru Kasivisvanathan (UCL) stated: "The PRIME results will transform healthcare and help us achieve our vision of every man with suspected prostate cancer who needs a prostate MRI scan being able to get one, no matter where they live or what their background or access to healthcare is."

More details in JAMA: Ng et al., "Biparametric vs Multiparametric MRI for Prostate Cancer Diagnosis: The PRIME Diagnostic Clinical Trial," JAMA, 2025. 
https://jamanetwork.com/journals/jama/fullarticle/2838799