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MRI + Blood Test Results May Cut Unnecessary Biopsies for Prostate Cancer

Medically reviewed by Carmen Pope, BPharm. Last updated on April 2, 2024.

By Lori Solomon HealthDay Reporter

TUESDAY, April 2, 2024 -- Prostate biopsies may not be necessary for patients with equivocal or negative magnetic resonance imaging (MRI) results and low prostate-specific antigen density (PSAD), according to a study published online March 29 in JAMA Network Open.

Arya Haj-Mirzaian, M.D., from Brigham and Women’s Hospital in Boston, and colleagues conducted a systematic literature review to determine the optimal prostate biopsy decision-making strategy for avoiding unnecessary biopsies and minimizing the risk for missing clinically significant prostate cancer (csPCa) by combining the MRI Prostate Imaging Reporting & Data System (PI-RADS) and clinical data.

Based on 72 included studies (36,366 patients), the researchers found that PI-RADS category 4 lesions (β-coefficient, 7.82) and category 5 lesions (β-coefficient, 23.18) were significantly associated with a higher risk for csPCa. When considered jointly in a multivariable model, the only clinical variable significantly associated with csPCa besides PI-RADS category 5 lesions (β-coefficient, 9.19) was PSAD (β-coefficient, 15.50). There was a 30 percent reduction in unnecessary biopsies by avoiding biopsy in patients with lesions with PI-RADS category ≤3 and PSAD <0.10 ng/mL2 compared with performing biopsy in all suspected patients. This strategy had an estimated sensitivity of 97 percent (versus 95 percent with performing biopsy in all suspected patients) and a number needed to harm of 17 (versus 15).

"These findings suggest that in patients with suspected csPCa, patient-tailored prostate biopsy decisions based on PI-RADS and PSAD could prevent unnecessary procedures while maintaining high sensitivity," the authors write.

Abstract/Full Text

Disclaimer: Statistical data in medical articles provide general trends and do not pertain to individuals. Individual factors can vary greatly. Always seek personalized medical advice for individual healthcare decisions.

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