Andre Luis de Castro Abreu, MD
Several studies presented at this year’s American Urological Association (AUA) meeting underscored the value of multiparametric magnetic resonance imaging (mpMRI) in the diagnosis and management of prostate cancer. According to the findings, the use of mpMRI in combination with other tools for diagnosis can reduce unnecessary prostate biopsies. They also indicated that use of mpMRI is on the rise, particularly in men aged 60 to 65.
However, NPV ranged between 72% and 89%, depending on the definition of clinically significant prostate cancer.
Figure. PSA Test Compliance Rate Significantly Higher than Biopsy Compliance Rate6
Combining PHI and mpMRI
The Prostate Health Index (PHI) and mpMRI have been used independently to predict prostate cancer grade reclassification (Gleason score >6) for patients on active surveillance (AS). Results from a study reported at the AUA meeting showed that combining these tools would have enabled more accurate prediction of grade reclassification at surveillance biopsy than use of mpMRI or PHI alone. Further, the combination of these tools would have eliminated the need for repeat biopsy in about 20% of cases.4
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