The clinical utility of prostate MRI before biopsy

Approximately 1 in 8 men are diagnosed with prostate cancer during their lifetime. However, long-term data have shown that as many as half of diagnosed prostate cancers have low lethal potential. Early detection of prostate cancer relying on PSA alone is associated with potential harm to patients owing to false-positive results, prostate biopsy-related complications and over-detection and over-treatment of low-risk cancers. Multiparametric MRI offers an adjunctive strategy for improving the diagnostic yield of prostate biopsy and also for potentially reducing the need for biopsy in selected patients. Prostate MRI can increase the detection of clinically significant prostate cancer through targeted biopsy, especially in patients with a previous negative biopsy who did not undergo initial imaging. Prostate MRI improves clinically significant cancer detection, potentially reducing biopsy burden in patients on active surveillance.