Benefits of pre-biopsy multi-parametric magnetic resonance imaging scanning in the initial assessment of prostate cancer

Traditionally, men referred for investigation of raised prostate specific antigen (PSA) could expect to be investigated via blind TRUS biopsy. In recent years, the availability of pre-biopsy imaging with multi-parametric magnetic resonance imaging (mp-MRI) has allowed urology centres to improve their triage and care of this patient cohort. The ability to identify discrete lesions for more accurately targeted TRUS, stream patients with anterior lesions for trans-perineal biopsy, and of course to prevent those with no evidence of clinically significant prostate cancer from being subjected to unnecessary procedures has proved pre-biopsy mp-MRI a valuable tool in the assessment and diagnosis of prostate cancer. Our service recently audited the impact of the introduction of mp-MRI on our prostate cancer assessment pathway. An analysis of the outcomes of 1558 referrals over a 2-year period, and found that pre-biopsy imaging has resulted in a marked reduction in unnecessary procedures and more accurate targeting of lesions, leading to improved outcomes for patients.