“Biggest leap in decades” for prostate cancer, 1 in 4 could avoid biopsies

The trial of 576 men took place across 11 hospitals. The patients, who all possessed high prostate specific antigen (PSA) levels, were scanned using multi-parametric MRI, which identifies cancer size, cell density and connection to the bloodstream. Though traditionally men with high PSA levels are sent for a biopsy, the scan found that 27% did not need one at all. Furthermore, the scan enabled 93% of aggressive cancers to be detected by informing biopsy use, compared to randomly enacted biopsies.

Lead author Dr Hashim Ahmed at University College London, UK, commented: "Prostate cancer has aggressive and harmless forms. Our current biopsy test can be inaccurate because the tissue samples are taken at random. This means it cannot confirm whether a cancer is aggressive or not and can miss aggressive cancers that are actually there. Because of this some men with no cancer or harmless cancers are sometimes given the wrong diagnosis and are then treated even though this offers no survival benefit and can often cause side effects. On top of these errors in diagnosis, the current biopsy test can cause side effects such as bleeding, pain and serious infections."

"Our results show that MP-MRI should be used before biopsy," he continued. "Our study found that using the two tests could reduce over-diagnosis of harmless cancers by 5%, prevent one in four men having an unnecessary biopsy, and improve the detection of aggressive cancers from 48% to 93%. While combining the two tests gives better results than biopsy alone, this is still not 100% accurate so it would be important that men would still be monitored after their MP-MRI scan. Biopsies will still be needed if an MP-MRI scan shows suspected cancer too, but the scan could help to guide the biopsy so that fewer and better biopsies are taken."

Over 10,000 biopsies are carried out in the UK each year; the NHS is already reviewing the possibility of utilising the advanced scan in regular practice.