Multiparametric MRI for Detecting Prostate Cancer

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Urologists are exploring the systematic integration of newer diagnostic tools for identifying men who may be at high risk for prostate cancer but are not being identified by traditional biopsy techniques. In this segment, Neal D. Shore, MD, FACS, and Sanford J. Siegel, MD, FACS, describe how one of these tools, the multiparametric MRI fusion biopsy, is poised to become the new standard of care.

Multiparametric MRI fusion has the potential for greater sensitivity for where to direct your biopsies, perhaps even avoid biopsies, by finding higher index lesions. Based on this increased sensitivity over traditional biopsy and ultrasound, multiparametric MRI fusion has clear benefits to both the urologist and the patient. According to Shore, the challenge right now is the promotion of the best patient care in heterogeneous markets.

Siegel expresses his concerns that many patients with atypia on their prostate biopsy are not receiving adequate follow-up. Although multiparametric MRI fusion is considered a “disruptive technology,” it promises to support the practice of active surveillance for this category of patient.

Widespread adoption of multiparametric MRI fusion is still controversial. The size of the market, the level of competition, and reimbursement models may all affect a urology practice’s decision to adopt MRI fusion as a component of its diagnostic algorithm.