Shifts in Diagnostic Approaches for Prostate Cancer: Impact of MRI-Informed Biopsies on Low-Risk Cancer Detection.
[BACKGROUND] With the shift in prostate cancer (PCa) diagnosis from systematic biopsies to magnetic resonance imaging (MRI)-informed biopsies, we aimed to investigate the changing diagnostic practices
- 표본수 (n) 10
- p-value p = 0.012
- p-value p = 0.047
APA
Tohi Y, Kato T, et al. (2025). Shifts in Diagnostic Approaches for Prostate Cancer: Impact of MRI-Informed Biopsies on Low-Risk Cancer Detection.. International journal of urology : official journal of the Japanese Urological Association, 32(11), 1622-1627. https://doi.org/10.1111/iju.70193
MLA
Tohi Y, et al.. "Shifts in Diagnostic Approaches for Prostate Cancer: Impact of MRI-Informed Biopsies on Low-Risk Cancer Detection.." International journal of urology : official journal of the Japanese Urological Association, vol. 32, no. 11, 2025, pp. 1622-1627.
PMID
40755150
Abstract
[BACKGROUND] With the shift in prostate cancer (PCa) diagnosis from systematic biopsies to magnetic resonance imaging (MRI)-informed biopsies, we aimed to investigate the changing diagnostic practices of urologists and the impact of MRI on the detection of low-risk PCa.
[METHODS] We conducted a retrospective analysis of 698 patients referred for PCa management at the Department of Urology, Kagawa University Hospital, between June 2014 and December 2023. Patients receiving dutasteride treatment (n = 10) were excluded. We assessed longitudinal trends in patient age, PSA levels, utilization rates of digital rectal examination (DRE) and MRI, and the diagnosis of D'Amico low-risk PCa. Predictive factors for low-risk PCa diagnosis were also analyzed.
[RESULTS] The median age at diagnosis was 71 years (interquartile range [IQR], 66-76), and the median PSA level was 7.14 ng/mL (IQR, 5.29-12.07), both of which showed a significant upward trend over time (age: R = 0.5687, p = 0.012; PSA: R = 0.4076, p = 0.047). The frequency of DRE significantly decreased (R = 0.8306, p < 0.001), while MRI use increased significantly from 36.4% in 2014 to 92.1% in 2023 (R = 0.8960, p < 0.001). Concurrently, the proportion of D'Amico low-risk PCa diagnoses declined from 22.7% in 2014 to 10.5% in 2023 (R = 0.6122, p = 0.008). Multivariate logistic regression revealed that MRI-informed biopsies were significantly associated with a reduced likelihood of detecting low-risk PCa (Odds ratio = 0.578, 95% confidence interval = 0.366-0.911, p = 0.018).
[CONCLUSION] The increasing use of MRI-informed biopsies in the diagnosis of PCa has shifted clinical practice, potentially contributing to the reduced detection of low-risk PCa.
[METHODS] We conducted a retrospective analysis of 698 patients referred for PCa management at the Department of Urology, Kagawa University Hospital, between June 2014 and December 2023. Patients receiving dutasteride treatment (n = 10) were excluded. We assessed longitudinal trends in patient age, PSA levels, utilization rates of digital rectal examination (DRE) and MRI, and the diagnosis of D'Amico low-risk PCa. Predictive factors for low-risk PCa diagnosis were also analyzed.
[RESULTS] The median age at diagnosis was 71 years (interquartile range [IQR], 66-76), and the median PSA level was 7.14 ng/mL (IQR, 5.29-12.07), both of which showed a significant upward trend over time (age: R = 0.5687, p = 0.012; PSA: R = 0.4076, p = 0.047). The frequency of DRE significantly decreased (R = 0.8306, p < 0.001), while MRI use increased significantly from 36.4% in 2014 to 92.1% in 2023 (R = 0.8960, p < 0.001). Concurrently, the proportion of D'Amico low-risk PCa diagnoses declined from 22.7% in 2014 to 10.5% in 2023 (R = 0.6122, p = 0.008). Multivariate logistic regression revealed that MRI-informed biopsies were significantly associated with a reduced likelihood of detecting low-risk PCa (Odds ratio = 0.578, 95% confidence interval = 0.366-0.911, p = 0.018).
[CONCLUSION] The increasing use of MRI-informed biopsies in the diagnosis of PCa has shifted clinical practice, potentially contributing to the reduced detection of low-risk PCa.
MeSH Terms
Humans; Male; Prostatic Neoplasms; Aged; Retrospective Studies; Magnetic Resonance Imaging; Prostate-Specific Antigen; Prostate; Digital Rectal Examination; Image-Guided Biopsy; Risk Assessment; Biopsy; Practice Patterns, Physicians'
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