MRI-prostaat voorafgaand aan het eerste consult: efficiënt? Of niet geïndiceerd?

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2024年5月13日

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Daniel C. Maas,
K. Tim Buddingh,
Philip Oldenburg,
Steven F. de Walle,
Derek W. Wolterbeek,
Remco R. de Vries

摘要

Introduction

For reasons of efficiency and patient-friendliness, we started a pilot in 2020 to perform an ‘upfront’ MRI in men under 75 years of age and a PSA (prostate specific antigen) above 5 ug/L. The aim of this study was to evaluate how many MRIs, according to the Rotterdam Prostate Cancer Risk Calculator (RPCRC-3/4), were not indicated.

Material and methods

197 upfront MRIs were performed. An MRI was considered not indicated if the risk of detecting prostate cancer on biopsy was < 12.5% and the risk of high-grade or advanced prostate cancer was < 4%.

Results

In 197 men with upfront MRI, 50 were considered not indicated (26%) according to the RPCRC. In men with a PSA between 5 to 7, 34/74 (46%) of the MRIs were not indicated. In men with a PSA > 7, 16/123 (13%) of the MRIs were not indicated.

Conclusion

Performing an MRI prostate before the initial consultation leads to a substantial number of not indicated MRIs in men with a PSA < 7. With a PSA > 7, the MRI, based on the RPCRP-3/4, is almost always justified.