Significant prostate cancer after negative MRI and systematic biopsy.

MRI scan of the prostate has become standard of care in patients with a raised PSA test in the absence of a urine infection before a prostate biopsy is performed. It is around 85% accurate. So, the question is what to do if the PSA is persistently raised or there is clinical suspicion of prostate cancer due to an abnormal feeling gland, despite a previous biopsy showing no cancer or a benign looking MRI scan?

This was studied in a subgroup of >400 men from the FUTURE trial who had thorough systematic biopsies of the prostate through the rectum. This is otherwise known as TRUS biopsies.

In those men with non-suspicious MRI a clinically significant prostate cancer was diagnosed in 3%. This means that the risk of prostate cancer in this group of patients is low. However, compared to the general population the risk of diagnosing significant prostate cancer remains higher and follow-up in recommended.

In our practice, prostate biopsies are performed through the perineum, thus avoiding the rectum. We target the suspicious areas on MRI and add systematic biopsies to other parts of the prostate so as not to miss MRI invisible cancers. So, our pickup rate is higher than in TRUS biopsies. We also have a lower risk of sepsis by avoiding the rectum.

I also think that PSMA PET scanning will play a greater role in picking up significant cancers by increasing the sensitivity of MRI.

For the full article, please click here.

Social media accounts


The London Clinic

145 Harley Street, London


Fax: 0203 219 3236

Site Made with ♥️ By Gossh Expert 2xN

We use cookies to allow us to better understand how the site is used. By continuing to use this site, you consent to this policy. Click to learn more