The Imaging Findings of an Abbreviated Biparametric MRI Protocol for Prostate Cancer Screening

Motivation: Prostate cancer (PCa) screening via prostate-specific antigen (PSA) testing is prone to over- and under-diagnosis. MRI shows promise but is hindered by long scan times, cost and limited availability. Goal(s): To evaluate the imaging findings of an abbreviated biparametric (bp)MRI protocol for PCa screening. Approach: The ReIMAGINE study screened men aged 50-75 with PSA testing and an abbreviated MRI. Positive MRI or raised PSA density ≥0.12 ng/mL² (PSAd) triggered follow-up with multiparametric MRI +/- biopsy. Results: One in six men had a positive screening MRI. The screening MRI detected more clinically significant cancers than PSAd alone, with a positive predictive value of 59%. Impact: Prostate MRI may have value in prostate cancer screening independently of prostate-specific antigen testing, offering an opportunity for early cancer detection. Future research is needed to optimise the screening approach to make MRI a more feasible, cost-effective screening tool.