Two-thirds of men with a positive screening MRI for prostate cancer had PSA levels below 3 ng/mL and 91 percent of these men had clinically significant prostate cancer, according to newly published research.
Emerging research findings emphasize the role of magnetic resonance imaging (MRI) in detecting clinically significant prostate cancer (csPCa) in men with normal prostate-specific antigen (PSA) levels.
For the study, recently published in BMJ Oncology, researchers assessed data from 303 men who had a screening non-contrast MRI (sMRI) and PSA testing. Positive findings for prostate cancer were defined as a positive sMRI or PSA density > 0.12 ng/mL, according to the study. The study authors noted that PSA density was obtained by measuring prostate volume on sMRI.
Forty-eight men had positive sMRI findings for prostate cancer with 32 of the men having a PSA level below 3 ng/mL. The researchers also pointed out that 60 percent (15 of 25 men) of those with a positive MRI and csPCa had a PSA below 3 ng/mL. Subsequent biopsy results in these patients included 13 Gleason 3+4 cancers, according to the study.
“The finding in this report … that 2 in 3 men with a positive screening MRI have a PSA < 3 ng/mL is a sobering one because MRI lesions are positively associated with clinically significant cancer. Using MRI to detect cancers can allow pick up of significant lesions before the PSA has begun to rise … (and offers) an opportunity for early detection,” wrote lead study author Caroline M. Moore, M.D., a professor of urology in the Department of Targeted Intervention within the Division of Surgery and Interventional Science at University College London in the United Kingdom, and colleagues.
Out of the 255 study participants who had a negative sMRI, the researchers found that 16 men had a greater PSA density than 0.12 ng/mL (a measurement determined by assessing prostate volume on sMRI). The study authors found that four of these men had csPCa and one man had clinically insignificant prostate cancer.
“In clinical practice, we recognize that the PSA test has limitations in the identification of men at risk for prostate cancer. MRI may allow us an alternative way to assess prostate cancer risk in men in the community,” added Moore and colleagues.
While acknowledging lower numbers of Black (13 participants, 5 percent of cohort) and Asian study participants (10 participants, 3 percent of cohort), the study authors said logistic regression analysis demonstrated significantly higher PSA density in Black and Asian men. The researchers also noted that none of the 13 Black study participants had positive MRI findings for prostate cancer.
(Editor’s note: For additional articles on prostate cancer imaging, see https://www.diagnosticimaging.com/clinical/prostate-cancer .)
ACR Collaborative Model Achieves 20 Percent Improvement in PI-QUAL Scores for Prostate MRI
May 9th 2024Using a learning network model to discuss challenges and share insights among radiology departments from five different organizations, researchers noted that 87 percent of audited prostate MRI exams had PI-QUAL scores > 4 at the conclusion of the collaborative program.
MRI-Based Deep Learning Algorithm Shows Comparable Detection of csPCa to Radiologists
May 8th 2024In a study involving over 1,000 visible prostate lesions on biparametric MRI, a deep learning algorithm detected 96 percent of clinically significant prostate cancer (csPCa) in comparison to a 98 percent detection rate for an expert genitourinary radiologist.
Emerging Perspectives on PSMA PET Radiotracers: An Interview with Kenneth J. Pienta, MD
April 24th 2024In a recent interview, Kenneth J. Pienta, M.D., discussed the impact of piflufolastat F18, current directions in research with other PSMA-targeted radiotracers and future possibilities for the role of PSMA PET in the imaging paradigm for prostate cancer.