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Cancer Detection and Surveillance Pathways with Abbreviated MRI in the Prostate, Pancreas, and Liver: A
Hannah Brown1, Sharon E Clarke2,3
1School of Medicine, Queen's University, Kingston, ON K7L 3N6, Canada.
Abstract:
Magnetic resonance imaging (MRI) plays an essential role in cancer detection and surveillance, yet complete MRI (C-MRI) protocols are lengthy, resource-intensive, and may limit access within population-level cancer care pathways. Abbreviated MRI (A-MRI) protocols have emerged as a streamlined alternative that may preserve diagnostic performance while reducing examination time, cost, and IV contrast exposure. We conducted a narrative review of studies published between 2015 and 2025 evaluating A-MRI in prostate cancer detection and surveillance, pancreatic cystic lesion surveillance, and hepatocellular carcinoma (HCC) surveillance. Evidence was synthesized qualitatively with emphasis on potential advantages, limitations, guideline positions, and evidence gaps. Across the organ systems assessed, A-MRI may demonstrate diagnostic performance comparable to C-MRI in selected clinical contexts. Biparametric MRI has demonstrated noninferior detection of clinically significant prostate cancer; non-contrast A-MRI may be considered for the surveillance of selected low-risk pancreatic cystic lesions, and A-MRI may offer higher sensitivity than ultrasound for HCC surveillance in patients with suboptimal ultrasound visualization. Heterogeneity in the available literature and limited prospective outcome data remain important limitations. Overall, A-MRI represents a complementary, risk-adapted strategy rather than a universal replacement for C-MRI, and further prospective studies are needed to define optimal patient selection and long-term oncologic benefit.
Insights
Abbreviated MRI (A-MRI) offers a faster, less costly alternative to complete MRI (C-MRI) for cancer surveillance. Studies show A-MRI may match C-MRI
Area of Science:
- Radiology and Medical Imaging
- Oncology
- Diagnostic Imaging
Background:
- Complete MRI (C-MRI) protocols are lengthy and resource-intensive, potentially limiting access in cancer care.
- Abbreviated MRI (A-MRI) protocols offer a streamlined alternative, reducing time, cost, and contrast agent use.
- A-MRI aims to maintain diagnostic performance while improving efficiency and patient experience.
Purpose of the Study:
- To review the literature on Abbreviated MRI (A-MRI) for cancer detection and surveillance.
- To evaluate A-MRI's diagnostic performance, advantages, and limitations in prostate cancer, pancreatic cysts, and hepatocellular carcinoma (HCC).
- To identify evidence gaps and guideline positions for A-MRI implementation.
Main Methods:
- A narrative review of studies published between 2015 and 2025.
- Qualitative synthesis of evidence focusing on diagnostic performance, clinical utility, and limitations.
- Assessment of A-MRI applications in prostate cancer, pancreatic cystic lesions, and HCC surveillance.
Main Results:
- A-MRI demonstrated comparable diagnostic performance to C-MRI in specific clinical scenarios.
- Biparametric MRI showed noninferior detection of clinically significant prostate cancer.
- Non-contrast A-MRI is suitable for selected pancreatic cysts; A-MRI may improve HCC surveillance sensitivity over ultrasound.
Conclusions:
- A-MRI is a complementary strategy, not a universal replacement for C-MRI.
- Further prospective studies are needed to optimize patient selection and confirm long-term oncologic benefits.
- A-MRI represents a risk-adapted approach to cancer surveillance, enhancing accessibility and efficiency.
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