Incidental findings on prostate MRI in a population-based screening setting

Area of Science:

• Radiology
• Oncology
• Medical Screening

Background:

• Prostate MRI is increasingly used for cancer screening.
• Incidental findings on screening MRI can pose challenges for reporting and patient management.
• Standardized reporting protocols for incidental findings are lacking.

Purpose of the Study:

• To determine the frequency and types of incidental findings during prostate MRI screening.
• To assess the clinical relevance of these incidental findings.
• To evaluate inter-regional variations in reporting incidental findings.

Main Methods:

• Analysis of prostate MRI reports from 2020-2024 in Swedish organised prostate cancer testing (OPT) programs.
• Inclusion of men aged 50-56 years.
• Categorization of incidental findings based on clinical relevance and statistical analysis of regional differences.

Main Results:

• Incidental findings were reported in 9.9% of prostate MRI scans.
• Most findings (87%) were of low or no clinical relevance (e.g., inguinal hernia, diverticulosis).
• Clinically significant findings (suspected malignancy, metastases) occurred in 1.4% of reports, with regional variations noted.

Conclusions:

• Prostate MRI screening in asymptomatic men in their fifties yields a low rate of clinically significant incidental findings.
• Significant variation exists in the reporting of low-clinical-relevance incidental findings across different centers.
• Development of consensus-based guidelines is crucial for standardizing the reporting and notification of incidental findings from prostate MRI screening.