The first study to compare bi-parametric MRI, ultrasound and PSA as a screening test for prostate cancer has been recently published in JAMA Oncology.
The findings of the group of Prof. H. Ahmed, Imperial College London, UK are promising and show that bi-parametric MRI not only shortens scan times and eliminates gadolinium exposure, but it also finds more clinically significant prostate cancers.
This study suggests that when screening the general population for prostate cancer, MRI using a score of 4 or 5 to define a positive test result, compared with PSA testing alone at a level of 3 ng/mL or higher, might lead to more men being diagnosed with clinically significant cancer, without increasing the number of men advised to undergo biopsy or be overdiagnosed with clinically insignificant cancer.
In addition, the findings suggest that ultrasonography is unlikely to have better performance characteristics compared with PSA testing alone.
In an accompanying editorial, experts from Massachusetts General Hospital, Boston, USA noticed these results set the stage for additional investigations on how imaging can be used for population-based prostate cancer screenings. However, the findings indicate that MRI will play an important role in this.