MP53-09 SINGLE-CENTRE EXPERIENCE WITH SYSTEMATIC TRANSPERINEAL STEREOTACTIC PROSTATE BIOPSY PLUS MAGNETIC RESONANCE IMAGING TARGETED, TRANSRECTAL ULTRASOUND GUIDED FUSION BIOPSY
2016
Among these providers, urologists accounted for the largest number of studies ordered (57.2%), followed by hematologist/oncologists (14.1%) and radiation oncologists (15.1%). The remaining studies were ordered by primary care providers, nurse practitioners, nephrologists, radiologists and general surgeons. The most common indications for ordering a prostate MRI were initial staging/restaging patients who had not undergone treatment and were not on active surveillance (51.1%), rising prostate-specific antigen (PSA) with negative biopsy (18.5%), active surveillance (10.9%) and surveillance following prostatectomy or radiation (7.7%). The MRI results revealed positive findings in 28.6%, negative findings in 23.7% and indeterminate findings in 17.4% of cases. CONCLUSIONS: This study demonstrates a rapidly rising trend in the utilization of prostate MRIs despite the absence of established guidelines to support its use. While there is some evidence to suggest the potential value of MRIs, particularly in detecting prostate cancer in men with elevated PSAs and negative biopsies, most studies were being ordered for prostate cancer staging and surveillance. Additionally, we found a significant number of indeterminate cases. This brings into question whether MRIs are linked to improved clinical outcomes at such high costs to the health care system. In light of these results, it will be important to develop clear guidelines for prostate MRI utilization given the trend in rapid rate of adoption and utilization.
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