New £1.5m MRI research could rule out the need for a biopsy for thousands of men

Every year, thousands of men have a prostate biopsy after an MRI scan. It’s the gold standard way to diagnose prostate cancer, enabling doctors to see if the suspicious area on a scan is really cancer and, if so, how it might behave next.

But there’s a problem. Around half of these biopsies end up finding either no cancer, or a cancer that might never have harmed the man at all.

And although biopsies are even safer than they used to be, thanks to advances in how the samples are taken, they can still cause pain, bleeding or infection, as well as anxiety while men wait for the result.

Bobby, 72, had a biopsy as part of getting diagnosed. Although biopsies aren't always painful, his was. "I passed out when I had my biopsy," he says. "If some men don’t have to go through that, it’ll be a huge bonus."

Now, thanks to your support, we’re funding a new research project that could once again change the way we diagnose prostate cancer, sparing thousands of men a biopsy altogether.

ASPIRE, led by Professor Shonit Punwani at University College London, will test a new generation of MRI scans that could give doctors much more information about what’s happening inside the prostate. The aim is to help them tell more accurately which men really need a biopsy, and which men could safely avoid one.

"Nobody wants to have needles stuck through their perineum," says Professor Punwani. "If we can avoid some of those biopsies, not only do we help the NHS by reducing the cost, but each of those men is spared an unpleasant procedure."

Unlocking more information from MRI scans

Since we funded a pilot study into using MRI before biopsies back in 2009, MRI has gone on to revolutionise the way prostate cancer is diagnosed.

But, as always, there’s still room to make it better.

ASPIRE builds on earlier research we funded alongside Movember into an advanced scanning technique called VERDICT. VERDICT can be carried out using existing MRI machines, but it gives doctors more detailed information about the cells inside the prostate. That research showed VERDICT could help prevent around 90 per cent of these unnecessary biopsies.

The challenge now is making sure techniques like this work reliably outside a research setting. Different hospitals use different MRI machines, and they can produce slightly different results. Before doctors can use these scans routinely to decide whether a man needs a biopsy, researchers need to know that they can depend on the results wherever his scan takes place. That’s where ASPIRE comes in.

"The previous study we funded showed that the new scan is effective," says our Assistant Director of Research, Simon Grieveson. "Now, ASPIRE will assess if it works reliably on all existing types of NHS MRI scanner. This is the vital next step before it can go into a clinical trial and then, hopefully, be used in NHS hospitals."

From promising research to better tests for men

The researchers will compare three advanced MRI techniques, called VERDICT, fast VERDICT and RSI. They’ll set them up on MRI machines made by the three main manufacturers used in NHS hospitals, before testing them in a study involving 600 men across four hospitals.

They want to find out which technique is best at spotting the men who genuinely need a biopsy, and whether it gives reliable results on different MRI machines and in different hospitals.

At one hospital, the researchers will go a step further and use VERDICT scans to help make biopsy decisions. If a man’s scan suggests he doesn’t have serious cancer, he may be able to avoid a biopsy. He’ll then be followed up a year later to make sure nothing has been missed.

If ASPIRE is successful, it could pave the way for a larger national clinical trial and, ultimately, a new approach to prostate cancer diagnosis across the NHS.

This could mean that many men could avoid needing a biopsy altogether, avoiding the pain and anxiety that comes with it – and with an increasing number of prostate cancer diagnoses each year, this could free up capacity and resource in the NHS.

This will become even more critical if the UK moves to introduce a nationwide mass screening programme for prostate cancer, something that our £60m TRANSFORM study aims to achieve.

Fortunately, as the Imaging Lead on TRANSFORM, Prof Punwani will be perfectly placed to feed new knowledge and techniques from ASPIRE directly into this once-in-a-generation clinical trial.

Making the big breakthroughs possible

We’re investing £1,481,377 in ASPIRE through our Transformational Impact Awards, which support ambitious research with the potential to make a major difference to men’s lives.

But major investments like this are only possible because people choose to support our research.

As Professor Shonit Punwani puts it: "Funding research step by step can be difficult, but doing it properly can have a huge impact. I’m incredibly grateful to everyone who donates to Prostate Cancer UK. Your support makes ambitious studies like ASPIRE and TRANSFORM possible, helping researchers develop better ways to diagnose prostate cancer and benefit men for years to come."

A regular monthly donation helps us plan for the long term and back ambitious research like ASPIRE, giving researchers the support they need to turn promising discoveries into real improvements for men.

If you can, please set up a monthly gift today and help power the next breakthroughs in prostate cancer diagnosis and treatment.

Help fund life-changing research