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Study: Prostate MRIs better than standard biopsies in cancer detection

By Allen Cone

March 19 (UPI) -- An MRI scan in conjunction with targeted prostate biopsies may detect prostate cancer better than standard biopsies, according to an international study.

Researchers found the method finds more of the harmful prostate cancers but fewer of the harmless ones. University College London researchers published their findings Monday in the New England Journal of Medicine.

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For the Precision trial, researchers randomly enrolled 500 men with suspected prostate cancer from 23 international centers, including the United States, to receive either MRI targeted or standard screening between January 2016 to Dec. 31, 2017. Their average age was 64 and they had a PSA level of 20 ng per milliliter or less. Doctors generally have considered PSA levels of 4.0 and lower as normal, according to the U.S. National Cancer Institute.

"In men who need to have investigation for prostate cancer for the first time, Precision shows that using an MRI to identify suspected cancer in the prostate and performing a prostate biopsy targeted to the MRI information, leads to more cancers being diagnosed than the standard way that we have been performing prostate biopsy for the last 25 years," Veeru Kasivisvanathan, a researcher at UCL's Division of Surgery & Interventional Science, said in a press release.

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He also presented his findings at the 33rd European Association of Urology Congress in Copenhagen, Denmark, which runs until Tuesday.

In the MRI-targeted biopsy group, 28 percent of 252 men had MRI results that were not suggestive of prostate cancer, so they did not undergo biopsy. Clinically significant cancer was detected in 95 men, or 38 percent, in the MRI-targeted biopsy group compared, with 26 percent -- 64 of 248 participants -- in the standard-biopsy group.

Men with suspected prostate cancer typically undergo the standard biopsy called TRansrectal UltraSound guided prostate biopsy, or TRUS. A doctor passes an ultrasound probe into the rectum and takes a sample of cells from the prostate that might contain cancer.

This biopsy can miss harmful cancers and diagnose harmless cancers that don't need to be dealt with.

"This study was the first to allow men to avoid a biopsy," said Dr. Mark Emberton, a researcher in the UCL Division of Surgery & Interventional Science. "If high quality MRI can be achieved across Europe, then over a quarter of the one million men who currently undergo a biopsy could safely avoid it."

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