A Novel ‘Stage-Gated’ Approach for Reporting Prostate Screening MRI: “Is Less More?”
Motivation: Prostate MRI is a promising screening tool for prostate cancer, but it has a low positive predictive value (PPV), likely because assessment systems are not optimised for low disease prevalence. Goal(s): To evaluate whether a novel two-step, 'stage-gated' biparametric (bp)MRI reporting approach improves the PPV compared to conventional Likert/PI-RADS scoring designed for multiparametric (mp)MRI reading. Approach: 405 MRI scans from IP1-PROSTAGRAM underwent retrospective 'stage-gated' reporting: limited screening sequences (T2-weighted and b1500 diffusion-weighted images) were reviewed first, followed by the remaining bpMRI sequences if positive. Results: The 'stage-gated' bpMRI approach improved the PPV compared to bpMRI Likert/PI-RADS≥4 scoring and halved the number of biopsies. Impact: A 'stage-gated' reporting approach for prostate MRI screening improves the positive predictive value (PPV) compared to Likert/PI-RADS scoring while maintaining comparable cancer detection rates. This approach may prove valuable in reducing unnecessary biopsies in future prostate cancer screening trials.
Authors
- Hashim U. Ahmed (ORCID: https://orcid.org/0000-0003-1674-6723)
- Caroline M. Moore (ORCID: https://orcid.org/0000-0003-0202-7912)
- Natasha Thorley (ORCID: https://orcid.org/0000-0001-8928-895X)
- Tristan Barrett (ORCID: https://orcid.org/0000-0002-1180-1474)
- Giorgio Brembilla (ORCID: https://orcid.org/0000-0002-9690-8624)
- Anwar R. Padhani (ORCID: https://orcid.org/0000-0002-5830-5777)
- David Eldred‐Evans (ORCID: https://orcid.org/0000-0002-6861-8160)
- Penny L. Hubbard Cristinacce (ORCID: https://orcid.org/0000-0003-4213-3234)
- Nikhil Mayor (ORCID: https://orcid.org/0000-0003-2681-2501)
- Fiona Gong
- Tom Parry (ORCID: https://orcid.org/0000-0001-8300-926X)
- Heminder Sokhi (ORCID: https://orcid.org/0000-0003-0424-8356)
- Henry Tam
- Francesco Giganti
- Alistair Lamb
- Shonit Punwani
Publication Details
- Journal
- Proceedings on CD-ROM - International Society for Magnetic Resonance in Medicine. Scientific Meeting and Exhibition/Proceedings of the International Society for Magnetic Resonance in Medicine, Scientific Meeting and Exhibition
- Published
- 2025-09-16
- DOI
- https://doi.org/10.58530/2025/2277
- Primary Topic
- Prostate Cancer Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00