Speeding up scans for diagnosis
What you need to know
- Multiparametric MRI scans have been introduced in recent years to improve prostate cancer diagnosis, but as it is a precious resource, many men may not get access to one in the timely fashion required.
- Mr Veeru Kasivisvanathan will test to see if the scan times can be reduced without affecting the accuracy of the results
- If the shorter streamlined scans (biparametric MRI) are effective, it would relieve pressure on hospital waiting times and make these scans more easily available to all the men who need them
If this research shows that the contrast injection has limited value, then we can recommend a shorter and quicker MRI scan without contrast. This will allow many more scans to be done which will mean any man who needs a scan can get one and it will save the NHS money.
A new clinical trial of 500 men will test to see whether it’s possible to do advanced scans for diagnosis more quickly and cheaply without affecting the accuracy.
A revolution in diagnosis
Over the past few years, hospitals have introduced multiparametric MRI (mpMRI) scans as part of the diagnostic pathway for men suspected of having localised prostate cancer. The PROMIS trial showed that these advanced scans can help to rule out cancers and reduce the number of men having unnecessary biopsies. The PRECISION trial showed that they can also be used to target the biopsy if a suspicious area is seen in the prostate and reduce the chances of missing cancer.
A three-in-one scan
mpMRI scans take about 30-40 minutes and are actually three parts in one. One of these parts, which involves injecting a chemical known as contrast agent, takes about a third of this time. Mr Kasivisvanathan, a urologist who carried out the PRECISION trial, wants to see if this contrast scan is essential for giving accurate results.
This grant will fund a four-year travelling fellowship for Mr Kasivisvanathan to work at the Peter MacCallum Cancer Centre in Australia and set up a network between the UK and Australia for running cutting edge prostate cancer studies.
Breaking it down
From there, he will carry out a clinical trial called PRIME of 500 men with suspected prostate cancer. They will each have an mpMRI scan as usual, however the radiologists will only analyse the results from the streamlined biparametric MRI at first. Once they have reported the results, they will then be given the third part of the scan with the contrast agent and report the results again with this added information to see if it adds any value. If the MRI is suspicious, they will have a biopsy.
Saving time and money
The trial will analyse whether the contrast part of the scan makes a difference in detecting prostate cancers. If biparametric scans can maintain the same high level of accuracy as the multiparametric scans then it should be able to save time, money and resources for the NHS. The trial will also collect results to see how these scans affect the number of men being biopsied and their treatment options.
Not only will this research help to deliver better care for men, but it will give Mr Kasivisvanathan the experience and skills to develop his research group, allowing him to making breakthroughs for decades to come.
Grant information
Reference – TLD-PF19-004
Researcher – Mr Veeru Kasivisvanathan
Institution – University College London
Award - £349,968
