C.M.A. Hoeks, J.J. Fütterer, D.M. Somford, I.M. van Oort, H.J. Huisman & J.O. Barentsz
Two recent studies on prostate cancer screening gave conflicting results about the effects of screening on prostate cancer mortality. The current screening method of PSA determination in combination with transrectal ultrasonic biopsy leads to a large number of false positive results and overtreatment. A screening test is needed that reduces the number of unnecessary prostate biopsies and which discriminates between more and less aggressive forms of prostate cancer. Multiparametric MRI has a high specificity for prostate cancer detection and provides information about prostate cancer aggressiveness. PSA in combination with multiparametric MRI performed at 1.5 Tesla appears to be a fairly accurate screening test. Due to its high costs and limited availability, multiparametric MRI is not suitable as a primary screening test. However, it could serve as a subsequent screening test if the PSA has increased above threshold values. Using multiparametric MRI as a follow-up test during screening would provide more accurate biopsies, prevent unnecessary prostate biopsies and improve the characterization of prostate cancer.