Using MRI to improve the diagnosis of prostate cancer

We funded Professors Hashim Ahmed and Mark Emberton from University College Hospital to study the potential for using multi-parametric MRI to improve the diagnosis of prostate cancer, which led to a multi-million pound trial that is changing clinical practice.

The standard procedure for diagnosis has been a PSA test followed by a TRUS biopsy. However, biopsies can have significant side-effects such as pain, bleeding and infection, which can require hospital admission. In addition, biopsies miss at least one in five cancers because doctors cannot see where the cancer is and the biopsy samples are taken randomly.

The researchers set out to find out if an advanced form of MRI could help to improve this by helping to identify where the cancer is in the prostate and reducing the number of men without cancer having a biopsy.

They analysed data from a previous study where men had a multi-parametric MRI scan and a biopsy, before then running a new pilot study comparing these scans to the ‘gold-standard’ that is template biopsies. Template biopsies are very invasive, requiring a general anaesthetic, but they offer a very thorough insight into the prostate which can provide a more accurate diagnosis.

The key finding from this study is that multi-parametric MRI could feasibly help to identify where the cancer is in the prostate as well as help to rule out cancer if the scan was clear. This meant that the scans could help to guide the biopsies to make them more accurate and reduce the number of unnecessary biopsies.

These early results provided the data and evidence needed for a £2 million trial, called PROMIS, funded by the National Institute for Health Research. This confirmed that mpMRI scans before biopsy would have a significant benefit for men, and is now already helping to change the lives of men. Prostate Cancer UK also provided further funding to the trial to collect blood and urine samples from the men taking part which will be a very valuable research resource when combined with the information from the template biopsies and mpMRI scans.

Grant information

Researchers – Professor Hashim Ahmed and Professor Mark Emberton
Institution – University College Hospital
Amount awarded – £47,540.00
Reference – G2009/23