Prostate cancer screening-stepping forward with MRI

ObjectiveTo comprehensively review the literature on the integration of MRI as a diagnostic tool in prostatecancer screening and offer practical recommendations for optimising its use.MethodsExisting research studies, clinical guidelines and expert opinions were reviewed to support the optimisation standards for MRI use in screening. Consolidated screening principles were used to make appropriate recommendations regarding the integration of MRI into the diagnostic pathway.ResultsTo strike a balance between the potential benefits of early detection on mortality and minimising the harm of over-diagnosing indolent cancers, it is necessary to have a clear understanding of the context of MRI use. The key to optimisation is patient selections and MRI-targeted biopsies. For men at higher-than-average risk, it is essential to use screening-specific MRI protocols and establish accuracy levels and interpretation criteria. Optimisation of readings by the automation of data acquisition, image quality monitoring, post-processing, radiologist certification and deep-learning computer-aided software is needed. The optimal utilisation of MRI involves its integration into a multistep diagnostic pathway, supported by a quality-assured and cost-effective infrastructure that ensures community-wide access to imaging.ConclusionMRI in the prostate cancer screening pathway can bring substantial diagnostic benefits. By carefullyconsidering its advantages, limitations and safety concerns and integrating it into a multistep diagnostic pathway, clinicians can improve outcomes while minimising harm to screening participants.

Automated summary

This article comprehensively reviews the integration of MRI as a diagnostic tool in prostate cancer screening and provides practical recommendations for optimizing its use. To strike a balance between the benefits of early detection and minimizing harm, understanding the context of MRI use is crucial. Patient selection and MRI-targeted biopsies are key to optimization, along with screening-specific MRI protocols and accuracy levels. Automation, image quality monitoring, post-processing, radiologist certification, and deep-learning computer-aided software contribute to improved readings. The optimal utilization of MRI involves integrating it into a multi-step diagnostic pathway with quality-assured, cost-effective infrastructure ensuring community-wide access.