A scaled-down MRI process can detect prostate cancers more quickly and at a lower cost than the current standard approach while maintaining similar accuracy, according to a peer-reviewed study published on Sept. 10 by the journal JAMA.
The study compared two types of MRI used to detect prostate cancer: biparametric and multiparametric, according to a statement from University College London (UCL), one of the institutions involved in the research.
Multiparametric MRI is a three-stage process that involves injecting a dye into the patient, while the biparametric approach is a shorter, two-stage process that avoids this step.
The study involved cancer experts from 22 hospitals in 12 countries, who recruited 555 men to compare the two MRI methods. The median participant age was 65.
“All patients underwent the full three-part scan. Radiologists then assessed the two-part scan without the dye, and separately assessed the three-part scan with the dye, for every patient,” UCL said in the statement. “A prostate biopsy was done when required to confirm whether or not the diagnosis was correct.”
Biparametric MRI was found to be “noninferior” to the multiparametric MRI process, the study concluded.
While the biparametric process detected clinically significant prostate cancer in 143 men, the multiparametric process made detections in 145 men.
Adopting the two-stage biparametric MRI can “reduce costs worldwide” when it comes to detecting prostate cancer, according to the “PRIME Diagnostic Clinical Trial” study.
“Currently around four million MRI scans are needed each year globally to diagnose prostate cancer. This demand is set to rise rapidly with a predicted surge in prostate cancer cases over the next 20 years,” the trial’s lead researcher and chief investigator, Veeru Kasivisvanathan, said.
“Time, cost and staff availability are all limiting factors in how many scans can be offered, which makes the results of the PRIME trial particularly important. If we can do the scan in up to half the time, with fewer staff and at lower cost, that will make a huge difference in allowing every man who needs a scan to be able to get one in a timely fashion.”
In the UK’s National Health Service, a three-phase MRI scan currently costs 273 pounds (about $370) on average, according to the UCL. In contrast, a two-phase MRI is 47 percent cheaper at 145 pounds (about $195). Currently, the three-part multiparametric MRI is the standard of care in the UK, UCL said.
The university said that “in countries like the US where healthcare costs tend to be much higher, the savings are likely to be even greater.”
“Despite the clear benefits of the MRI scan, in many healthcare settings around the world, men who need a scan still do not get one. For example, previous research has estimated that 35 percent of US prostate cancer patients received an MRI in 2022,” UCL said.
The arrival of speedier, inexpensive MRI scan options could change this scenario.
A prostate MRI can cost between $600 and $7,000 in the United States on average without insurance, according to an estimate by health care company Bettercare.
Avoiding the third step may also help avoid side effects.
In this stage, gadolinium, a rare earth element, is injected into the body as part of the dye to improve the quality of MRI images.
This dye “can on rare occasion cause mild side effects,” Francesco Giganti, a lead radiologist on the trial, said.
The trial was funded by the John Black Charitable Foundation, Prostate Cancer UK, the European Association of Urology Research Foundation, and the Wolfgang Dieckmann Foundation.
According to the American Cancer Society (ACS), about 313,780 new prostate cancer cases are estimated for this year in the United States, with roughly 35,770 people dying from the illness.
“Other than skin cancer, prostate cancer is the most common cancer in men in the United States,” ACS said.
Roughly one in eight men will be diagnosed with the illness during their lifetime, ACS said. The risk of prostate cancer will vary for each male depending on factors such as age and ethnicity.
“For example, prostate cancer is more likely to develop in older men. About 6 in 10 prostate cancers are diagnosed in men who are 65 or older, and it is rare in men under 40. The average age of men when they are first diagnosed is about 67,” ACS said.
In a Feb. 11 post, the Centers for Disease Control and Prevention said there are various treatment options for prostate cancer.
Patients could undergo a prostatectomy surgery where doctors remove the prostate. Alternatively, radiation therapy may be used, in which high-energy rays are utilized to kill the cancer, it said.
Other methods include chemotherapy, high-intensity focused ultrasound, and hormone therapy, the agency said.