A new standard for evaluating MR images to diagnose prostate cancer has been agreed upon by international radiological institutions and is now published in the journal European Urology. The new procedure reduces the over-diagnosis of insignificant cancers by up to 89 percent and assists in the diagnosis of up to 13 percent more life-threatening tumors than current procedures.

Ultrasound-guided transrectal biopsy is the current standard for prostate cancer diagnosis but it involves taking 10 to 12 prostate samples with an ultrasound-guided needle. The samples are then evaluated to determine if the patient has cancer and in many cases, the patients have non-cancerous swelling of the prostate or cancers that will most likely not cause harm.

Over the past few years, an imaging technique called multiparametric prostate magnetic resonance imaging (mpMRI) has gained interest for prostate cancer diagnosis. Many studies have proven that mpMRI improves the detection of most of the harmful tumors so that fewer patients have to undergo a biopsy.
In addition to good quality images, good guidelines are also needed to identify prostate cancer. In December 2014, draft global guidelines were released by the American College of Radiology (ACR), AdMeTech Foundation, and the European Society of Urogenital Radiology based on a five-year project.

An early version of the Prostate Imaging and Reporting and Data System (PI-RADS) has been found to improve the diagnosis of intermediate- to high-grade cancers. The new PI-RADS version 2 standardizes mpMRI and simplifies the way the scans are acquired, interpreted and reported.

"Early results have shown that mpMRI is an enormous help in detecting significant cancers,” Jelle Barentsz, professor at Radboud University Medical Centre in the Netherlands, said in a statement. “But to allow more widespread use, standardization of image acquisition and interpretation is needed. The new PIRADS protocols have the potential to bring real benefits to many patients, throughout the world.”

Barentsz noted that even though MR scanners are expensive pieces of equipment, it can bring down costs by reducing unnecessary treatment. He doesn’t believe that mpMRI will replace the ultrasound-biopsy method, but it will just be another option that urologists can use to diagnose prostate cancer.

Going forward, mpMRI will be brought into the mainstream, which will involve extensive training and education programs.

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