Frequency of biopsy and tumor grade before versus after introduction of prostate magnetic resonance imaging

In randomized clinical trials of patients with suspected prostate cancer, magnetic resonance imaging (MRI) before prostate biopsy has been associated with fewer biopsies, decreased detection of Gleason score 6 cancers, and increased detection of Gleason score 7 or higher cancers. It is not clear if these associations also exist in clinical practice. A cohort study of 23,802 Swedish men found that the use of MRI before a biopsy decision was associated with a lower proportion of men who underwent biopsy, detection of fewer Gleason score 6 cancers, and detection of more Gleason score 7 or higher cancers. The authors conclude that these data suggest that prostate MRI before biopsy may help reduce unnecessary biopsies.