By Carlos R. Hamilton III, M.D.
At Laser Prostate Centers of America, we believe that everyone should understand their options before selecting a treatment path. We aim to provide information to patients and equip them with the knowledge to make an informed decision for their health.
In the spirit of sharing information, here is a recent study from PROMIS (Patient-Reported Outcomes Measurement Information System) that illustrates the superiority of multi-parametric MRI (MP-MRI). PROMIS provides access to reliable, valid, and flexible measures of health status.
This study, funded by the UK Government Department of Health and National Institute of Health Research–Health Technology Assessment Programme, indicates that it was a prospective, multi-centre, paired-cohort, confirmatory study and the first to present blinded data on the diagnostic accuracy of both MP-MRI and TRUS-biopsy. In other words, this is a very well done and credible study.
The results of the study were published in The Lancet in January 2017. This is the largest study to date demonstrating that in patients with an elevated PSA if a multi-parametric MRI is performed before a TRUS biopsy (trans-rectal ultrasound guided biopsy), it can prevent unnecessary biopsies in up to 27% of patients. When the MRI is used as guidance for the biopsy up to 18% more clinically significant cancers are detected. Also 5% fewer clinically insignificant cancers are found saving men from unnecessary surgeries and complications of treatment.
Below is an excerpt from the study. If you’d like to learn more, you can read the full study and a commentary on it by following the links below.
“The main findings suggest that if MP-MRI was used as a triage test, one-quarter of men might safely avoid prostate biopsy. The high negative predictive value is reassuring in that a negative MP-MRI result implies a high probability of no clinically significant cancer. Further, over-diagnosis of clinically insignificant cancers might be reduced while detection of clinically significant cancers improved compared with the standard of TRUS-biopsy for all men.”
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