Meta-Analysis: Efficacy of MRI in prostate cancer screening for reducing unnecessary biopsies

This meta-analysis evaluated the effectiveness of incorporating magnetic resonance imaging (MRI) into prostate cancer screening pathways, compared to prostate-specific antigen (PSA)–only screening strategies. Analyzing data from 80,114 men across 12 studies, the findings demonstrate that MRI-based screening, particularly when using a sequential approach and a PI-RADS score ≥3 cutoff for biopsy, significantly increases the odds of detecting clinically significant prostate cancers (OR, 4.15) while reducing unnecessary biopsies (OR, 0.28) and detection of clinically insignificant cancers (OR, 0.34). Implementing a higher PI-RADS score of ≥4 further decreased the detection of insignificant cancers and biopsies performed, without impacting the detection rate of significant cancers. These results support the integration of MRI into screening programs to enhance diagnostic precision and reduce patient harm.

Reference (link to abstract – $ for full-text):

Tamás Fazekas et al. (2024). Magnetic Resonance Imaging in Prostate Cancer Screening:  A Systematic Review and Meta-Analysis. JAMA Oncol, Published online April 5, 2024. DOI: 10.1001/jamaoncol.2024.0734