MRI Plus New Score Halves Biopsy Rate for Prostate Cancer

MRI Plus New Score Halves Biopsy Rate for Prostate Cancer

Neil Osterweil

July 09, 2021

More good tidings to gladden the hearts of men who have reached the half century mark: Swapping traditional prostate biopsies for MRI-targeted biopsies with a new prostate cancer risk score can cut the number of unnecessary biopsies in half while still detecting clinically significant cancers.

The findings from the STHLM3MRI study, a large randomized trial, were published online in The New England Journal of Medicine to coincide with a presentation of the results at European Association of Urology 2021 Annual Meeting (EAU 2021).

The trial included nearly 2300 men with elevated prostate-specific antigen (PSA) levels and/or high scores on the Stockholm 3 predictive test.

They were randomly assigned to undergo either systematic biopsy or Stockholm 3 testing plus MRI with biopsy only of suspicious lesions.

The results show that the MRI-targeted strategy was associated with a 52% reduction in biopsy procedures compared with the systematic approach and a 69% reduction in detection of low-grade (Gleason score 6) cancers, reported Tobias Nordström, MD, PhD, from the Karolinska Institute, in Stockholm, Sweden.

“Combining the Stockholm 3 test with an MRI-targeted biopsy approach for prostate cancer screening decreases overdetection while maintaining detection of significant prostate cancer,” he said at the meeting.

“It is exciting to see breakthroughs such as this in the field of early detection of prostate cancer. An innovation such as STHLM3MRI makes an even more compelling case for the European Commission to ensure a risk-stratified approach to early detection of prostate cancer is adopted across the whole of Europe,” commented Hendrik Van Poppel, MD, PhD, adjunct secretary general of the EAU.

Although routine screening for breast and colorectal cancer is widely performed in Europe, to date, only Lithuania has established a nationwide program for prostate cancer screening, according to the EAU